Active NPI
Larissa Gushansky, DDS Inc.
- General Practice Dentistry
- South Gate, CA
National Provider Identifier
1154516680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- LARISSA GUSHANSKY, DDS INC.
- Practice address
- 3175 Firestone Blvd Ste 200
South Gate, CA 90280-2951 - Phone
- (323) 563-9124
- Fax
- (323) 563-9814
- NPI assigned
- Sep 7, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Larissa Gushansky, DDS
- Title
- Owner
- Phone
- (323) 563-9124
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
3175 Firestone Blvd Ste 200
South Gate, CA 90280-2951
Mailing address
3175 Firestone Blvd Ste 200
South Gate, CA 90280-2951
Phone (323) 563-9124
Other names 1
- State Dental Inc.
National Provider Directory
National Provider Directory- Tax ID family
- Larissa Gushansky DDS Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Dentist
- Pomona, CA
- NPI 1003000928
-
- General Practice Dentistry
- Pomona, CA
- NPI 1013102029
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": "1189123200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1638230400000",
"number": "1154516680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3175 FIRESTONE BLVD STE 200",
"city": "SOUTH GATE",
"state": "CA",
"postal_code": "902802951",
"telephone_number": "323-563-9124",
"fax_number": "323-563-9814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3175 FIRESTONE BLVD STE 200",
"city": "SOUTH GATE",
"state": "CA",
"postal_code": "902802951",
"telephone_number": "323-563-9124",
"fax_number": "323-563-9814"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LARISSA GUSHANSKY, DDS INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-09-07",
"last_updated": "2021-11-30",
"certification_date": "2021-11-30",
"status": "A",
"authorized_official_last_name": "GUSHANSKY",
"authorized_official_first_name": "LARISSA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "323-563-9124",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "State Dental Inc.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in South Gate, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.