Active NPI
Michael Wasserman, DDS
- Dentist
- Sherman Oaks, CA
National Provider Identifier
1073989067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 64936
- Practice address
- 14140 Magnolia Blvd
Sherman Oaks, CA 91423-1184 - Phone
- (818) 788-0937
- Fax
- (818) 788-5847
- NPI assigned
- Aug 13, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 64936 | CA | Primary |
Addresses
Primary practice location
14140 Magnolia Blvd
Sherman Oaks, CA 91423-1184
Mailing address
14140 Magnolia Blvd
Sherman Oaks, CA 91423-1184
Phone (818) 788-0937
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 6, 2016 through May 6, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64936 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439424000000",
"number": "1073989067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14140 MAGNOLIA BLVD",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914231184",
"telephone_number": "818-788-0937",
"fax_number": "818-788-5847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14140 MAGNOLIA BLVD",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914231184",
"telephone_number": "818-788-0937",
"fax_number": "818-788-5847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASSERMAN",
"first_name": "MICHAEL",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-13",
"last_updated": "2015-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "64936",
"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 Aug 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.