NPIMap

Organization Active NPI

Garrett Russikoff D.M.D., Inc.

  • Dentist
  • Northridge, CA
National Provider Identifier
1124599006
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
GARRETT RUSSIKOFF D.M.D., INC.
Practice address
18911 Nordhoff St Ste 35
Northridge, CA 91324-3784
Phone
(818) 701-5126
NPI assigned
Dec 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Authorized official

Name
Garrett Russikoff, DMD
Title
Presidet/ Ceo
Phone
(818) 701-5126

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

18911 Nordhoff St Ste 35
Northridge, CA 91324-3784

Mailing address

18911 Nordhoff St Ste 35
Northridge, CA 91324-3784
Phone (818) 701-5126

Other names 1

  • Woodstone Plaza Dental Doing business as

National Provider Directory

National Provider Directory

Locations

18911 Nordhoff St
Ste 35
Northridge, CA 91324
Phone (818) 701-5126

NPI Registry JSON

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545004800000",
    "number": "1124599006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18911 NORDHOFF ST STE 35",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243784",
            "telephone_number": "818-701-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18911 NORDHOFF ST STE 35",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243784",
            "telephone_number": "818-701-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARRETT RUSSIKOFF D.M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A",
        "authorized_official_last_name": "RUSSIKOFF",
        "authorized_official_first_name": "GARRETT",
        "authorized_official_title_or_position": "PRESIDET/ CEO",
        "authorized_official_telephone_number": "818-701-5126",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodstone Plaza Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; 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.