NPIMap

Organization Active NPI

Warren J. Gerosa, DDS,Inc.

Doing business as Dove Dental Spa

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1114214269
Registry record updated Jul 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33712 Issued in CA
Legal business name
WARREN J. GEROSA, DDS,INC.
Doing business as
Dove Dental Spa
Practice address
8540 S Sepulveda Blvd Ste 1212
Los Angeles, CA 90045-3819
Phone
(310) 645-2886
NPI assigned
Jul 8, 2011
Last updated
Jul 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2011

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

Authorized official

Name
Warren J Gerosa, DDSNPI 1326175951
Title
Ceo
Phone
(310) 645-2886

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 33712 CA Primary

Addresses

Primary practice location

8540 S Sepulveda Blvd Ste 1212
Los Angeles, CA 90045-3819

Mailing address

8540 S Sepulveda Blvd Ste 1212
Los Angeles, CA 90045-3819

Other names 1

  • Dove Dental Spa Doing business as

National Provider Directory

National Provider Directory

Locations

8540 S Sepulveda Blvd
Ste 1212
Los Angeles, CA 90045
Phone (310) 645-2886

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1114214269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8540 S SEPULVEDA BLVD STE 1212",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 S SEPULVEDA BLVD STE 1212",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453819",
            "telephone_number": "310-645-2886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN J. GEROSA, DDS,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-08",
        "last_updated": "2011-07-08",
        "status": "A",
        "authorized_official_last_name": "GEROSA",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-645-2886",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "33712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dove Dental Spa",
            "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 Jul 8, 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.