NPIMap

Organization Active NPI

Glosman Dental Group, LTD

Doing business as Dentalville

  • Dentist
  • Henderson, NV
National Provider Identifier
1073794418
Registry record updated Jun 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3580 Issued in NV
Legal business name
GLOSMAN DENTAL GROUP, LTD
Doing business as
Dentalville
Practice address
1351 W Sunset Rd
#100
Henderson, NV 89014-8608
Phone
(702) 835-1100
Fax
(702) 835-1101
NPI assigned
Nov 14, 2007
Last updated
Jun 6, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
GLOSMAN DENTAL GROUP, LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 6, 2013

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

Authorized official

Name
Monique R Gosman, DDS
Title
Cheif of Staff
Phone
(310) 480-2307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3580 NV Primary

Addresses

Primary practice location

1351 W Sunset Rd
#100
Henderson, NV 89014-8608

Mailing address

833 W Whittier Blvd
Montebello, CA 90640-4735
Phone (323) 266-1000

Other identifiers 1

IdentifierTypeStateIssuer
100512439MedicaidNV

Other names 1

  • Dentalville Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Glosman Dental Group LTD6 organizations share this tax ID, including this one
Part of
Glosman Dental Group LTD

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370476800000",
    "number": "1073794418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 W WHITTIER BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404735",
            "telephone_number": "323-266-1000",
            "fax_number": "323-372-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 W SUNSET RD",
            "address_2": "#100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890148608",
            "telephone_number": "702-835-1100",
            "fax_number": "702-835-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLOSMAN DENTAL GROUP, LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GLOSMAN DENTAL GROUP, LTD",
        "enumeration_date": "2007-11-14",
        "last_updated": "2013-06-06",
        "status": "A",
        "authorized_official_last_name": "GOSMAN",
        "authorized_official_first_name": "MONIQUE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHEIF OF STAFF",
        "authorized_official_telephone_number": "310-480-2307",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "3580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100512439",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentalville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; 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.