Crenshaw Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

44505 Issued in CA

Legal business name

CRENSHAW DENTAL GROUP

Practice address

3756 Santa Rosalia Dr
Suite 517
Los Angeles, CA 90008-3606

Phone

(323) 290-2212

Fax

(323) 290-1061

NPI assigned

Apr 3, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Moeiz Koshki, D.D.S.

Title

Dentist

Phone

(323) 290-2212

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083735278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3756 SANTA ROSALIA DR",
            "address_2": "SUITE 517",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900083606",
            "telephone_number": "323-290-2212",
            "fax_number": "323-290-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3756 SANTA ROSALIA DR",
            "address_2": "SUITE 517",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900083606",
            "telephone_number": "323-290-2212",
            "fax_number": "323-290-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRENSHAW DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOSHKI",
        "authorized_official_first_name": "MOEIZ",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "323-290-2212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madysyn Creighton
• Leanne Margaret Cremin
• Crenshaw Arf LLC
• Crenshaw Blvd Imaging Center, Inc. (Los Angeles Imaging Center)
• Crenshaw Community Center LLC (Crenshaw Community Center)
• Crenshaw Entrepreneurial Academy
• Crenshaw Family Medical Center, Inc
• Crenshaw Nursing Home LLC (Crenshaw Nursing Home)
• Crenshaw Pharmacy Inc
• Crenshaw Pharmcare Inc (Stocker RX Pharmacy)

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.