Individual provider Active NPI

Tatiana Vershinina, DDS

  • General Practice Dentistry
  • Beverly Hills, CA
National Provider Identifier
1053279703
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
111914 Issued in CA
Practice address
416 N Bedford Dr Ste 103
Beverly Hills, CA 90210-4308
Phone
(424) 302-0080
NPI assigned
Jan 12, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 111914 CA Primary

Addresses

Primary practice location

416 N Bedford Dr Ste 103
Beverly Hills, CA 90210-4308

Mailing address

416 N Bedford Dr Ste 103
Beverly Hills, CA 90210-4308
Phone (424) 302-0080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
111914CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1768176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1053279703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 N BEDFORD DR STE 103",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104308",
            "telephone_number": "424-302-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 N BEDFORD DR STE 103",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104308",
            "telephone_number": "424-302-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERSHININA",
        "first_name": "TATIANA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-12",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "111914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.