Individual provider Active NPI

Ricardo Raschkovsky

  • Periodontics
  • Beverly Hills, CA
National Provider Identifier
1174617518
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
CA47553 Issued in CA
Practice address
8929 Wilshire Blvd
Suite 220
Beverly Hills, CA 90211-1938
Phone
(310) 652-7800
Fax
(310) 652-7867
NPI assigned
Oct 2, 2006
Last updated
Dec 31, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X CA47553 CA Primary

Addresses

Primary practice location

8929 Wilshire Blvd
Suite 220
Beverly Hills, CA 90211-1938

Mailing address

8929 Wilshire Blvd
Suite 220
Beverly Hills, CA 90211-1938
Phone (310) 652-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CA47553CAMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1174617518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8929 WILSHIRE BLVD",
            "address_2": "SUITE 220",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111938",
            "telephone_number": "310-652-7800",
            "fax_number": "310-652-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8929 WILSHIRE BLVD",
            "address_2": "SUITE 220",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111938",
            "telephone_number": "310-652-7800",
            "fax_number": "310-652-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASCHKOVSKY",
        "first_name": "RICARDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "CA47553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2013; 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.