Active NPI
Tatiana Vershinina, DDS
- General Practice Dentistry
- Beverly Hills, CA
National Provider Identifier
1053279703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 111914
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 111914 | CA | MD | Marriage & 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.