Grigory Rozenovich, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D40115 Issued in CA

Practice address

3620 S. Bristol St. Suite 210
Santa Ana, CA 92704

Phone

(714) 549-1409

Fax

(714) 549-2118

NPI assigned

Oct 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Itzhak Failaev DDS Inc.

  • General Practice Dentistry
  • Santa Ana, CA
  • NPI 1689304222
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462406400000",
    "number": "1093891764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 S. BRISTOL ST. SUITE 210",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92704",
            "telephone_number": "714-549-1409",
            "fax_number": "714-549-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 S. BRISTOL ST. SUITE 210",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92704",
            "telephone_number": "714-549-1409",
            "fax_number": "714-549-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZENOVICH",
        "first_name": "GRIGORY",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2016-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "D40115",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40115",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Royale Health Care Center Inc. (Royale TRC)
• Royale Health Care Center Inc. (Royale Health Care Center)
• Noelle Royer-Schuurmans
• Robina Lee Royer
• Rozenovich & Ausker General Partnership
• Judith Lorraine Roznos
• Rpi Multi Specialty, Inc. (Elite Pi Medical Experts)
• RSCR California, Inc.
• RSCR California, Inc. (Olive Street Home)
• Isela Ibet Ruacho, REGISTERED NURSE

• General Practice Dentistry in Santa Ana, CA
• Providers in Santa Ana, 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 May 5, 2016; 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.