Individual provider Active NPI

Valeriy Rubtsov, DDS

  • General Practice Dentistry
  • Sherman Oaks, CA
National Provider Identifier
1073657524
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
54304 Issued in CA
Practice address
5535 Calhoun Ave
Sherman Oaks, CA 91401-4916
Phone
(818) 904-1152
NPI assigned
Feb 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 54304 CA Primary

Addresses

Primary practice location

5535 Calhoun Ave
Sherman Oaks, CA 91401-4916

Mailing address

5535 Calhoun Ave
Sherman Oaks, CA 91401-4916
Phone (818) 904-1152

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
54304CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073657524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 CALHOUN AVE",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914014916",
            "telephone_number": "818-904-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 CALHOUN AVE",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914014916",
            "telephone_number": "818-904-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBTSOV",
        "first_name": "VALERIY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.