NPIMap

Organization Active NPI

Dental Specialist of Los Angeles

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1083919781
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
34586 Issued in CA
Legal business name
DENTAL SPECIALIST OF LOS ANGELES
Practice address
3500 Whittier Blvd
101
Los Angeles, CA 90023-1746
Phone
(323) 264-8834
Fax
(323) 264-0885
NPI assigned
Jan 11, 2011
Organization subpart
Yes
Parent organization
GENTLE CARE DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

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

Authorized official

Name
Dr. Bertram Amiri, DDSNPI 1063619062
Title
President
Phone
(323) 264-8834

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 34586 CA Primary

Addresses

Primary practice location

3500 Whittier Blvd
101
Los Angeles, CA 90023-1746

Mailing address

3500 Whittier Blvd
101
Los Angeles, CA 90023-1746
Phone (323) 264-8834

Other names 1

  • Gentle Care Dental Doing business as

National Provider Directory

National Provider Directory
Part of
Dental Specialist of Los Angeles

Locations

3500 Whittier Blvd
Ste 101
Los Angeles, CA 90023
Phone (323) 264-8834

Practitioners & affiliated clinicians

Practitioners 1

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": "1294704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1083919781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 WHITTIER BLVD",
            "address_2": "101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900231746",
            "telephone_number": "323-264-8834",
            "fax_number": "323-264-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 WHITTIER BLVD",
            "address_2": "101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900231746",
            "telephone_number": "323-264-8834",
            "fax_number": "323-264-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SPECIALIST OF LOS ANGELES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENTLE CARE DENTAL",
        "enumeration_date": "2011-01-11",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "AMIRI",
        "authorized_official_first_name": "BERTRAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-264-8834",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "34586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentle Care Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 11, 2011; 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.