Sevak Elyaspoor DDS Professional Corp.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

53593 Issued in CA

Legal business name

SEVAK ELYASPOOR DDS PROFESSIONAL CORP.

Practice address

12125 Vanowen St Ste 2
North Hollywood, CA 91605-5665

Phone

(818) 764-4679

Fax

(818) 764-6382

NPI assigned

Sep 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Sevak Elyaspoor, DDSNPI 1295858504

Title

President

Phone

(818) 764-4679

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Sevak Elyaspoor, DDS

  • General Practice Dentistry
  • North Hollywood, CA
  • NPI 1295858504
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189036800000",
    "number": "1164617783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12125 VANOWEN ST STE 2",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916055665",
            "telephone_number": "818-764-4679",
            "fax_number": "818-764-6382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12125 VANOWEN ST STE 2",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916055665",
            "telephone_number": "818-764-4679",
            "fax_number": "818-764-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEVAK ELYASPOOR DDS PROFESSIONAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A",
        "authorized_official_last_name": "ELYASPOOR",
        "authorized_official_first_name": "SEVAK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-764-4679",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "53593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serendipity Home Health
• Serene Days Inc
• Serenity Nursing Services, Inc.
• Simona Benedetta Serio
• Lucilia Serrano
• Seven Ducks Therapy
• Seven Star Home Health Care, Inc
• Julie Sevigny
• Zachary John Sewalk
• SFM Medical Group Inc

• Dental Clinic/Center in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.