Jiten M Vasa, DDS., Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30025 Issued in CA

Legal business name

JITEN M VASA, DDS., INC

Practice address

11455 Carson St Ste E
Lakewood, CA 90715-2581

Phone

(562) 860-7116

Fax

(562) 860-7115

NPI assigned

May 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jiten M Vasa, DDSNPI 1326258708

Title

Owner Dentist

Phone

(562) 860-7116

Specialties & licenses 1

Addresses

Other names 1

• Lakewood Family Dentistry Other name

Locations

Practitioners 2

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

• Jiten M Vasa, DDS

  • General Practice Dentistry
  • Lakewood, CA
  • NPI 1326258708
  NPD (past) Authorized official
• Ankit J Vasa, DDS

  • Dentist
  • Lakewood, CA
  • NPI 1558641720
  NPD (past)

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276732800000",
    "number": "1114137338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11455 CARSON ST STE E",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907152581",
            "telephone_number": "562-860-7116",
            "fax_number": "562-860-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11455 CARSON ST STE E",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907152581",
            "telephone_number": "562-860-7116",
            "fax_number": "562-860-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JITEN M VASA, DDS., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2010-06-17",
        "status": "A",
        "authorized_official_last_name": "VASA",
        "authorized_official_first_name": "JITEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "562-860-7116",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "30025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakewood Family Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Norman Bruce Jetton, MD
• Sharon Jimenez
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• Aprel Johnson-Gabriel
• Alice Johnson, NP
• Erika Johnson

• General Practice Dentistry in Lakewood, CA
• Providers in Lakewood, 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 Jun 17, 2010; 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.