NPIMap

Organization Active NPI

Raanan Dental Group Brentwood Inc.

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1083309470
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
RAANAN DENTAL GROUP BRENTWOOD INC.
Practice address
11980 San Vicente Blvd Ste 811
Los Angeles, CA 90049-6606
Phone
(310) 826-8911
NPI assigned
Apr 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Authorized official

Name
Sol Chum
Title
Ops Manager
Phone
(971) 226-4135

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

11980 San Vicente Blvd Ste 811
Los Angeles, CA 90049-6606

Mailing address

11980 San Vicente Blvd Ste 811
Los Angeles, CA 90049-6606
Phone (310) 826-8911

National Provider Directory

National Provider Directory

Locations

11980 San Vicente Blvd
Ste 811
Los Angeles, CA 90049
Phone (310) 826-8911

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681084800000",
    "number": "1083309470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11980 SAN VICENTE BLVD STE 811",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496606",
            "telephone_number": "310-826-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11980 SAN VICENTE BLVD STE 811",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496606",
            "telephone_number": "310-826-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAANAN DENTAL GROUP BRENTWOOD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A",
        "authorized_official_last_name": "CHUM",
        "authorized_official_first_name": "SOL",
        "authorized_official_title_or_position": "OPS MANAGER",
        "authorized_official_telephone_number": "971-226-4135"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; 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.