Active NPI
Michael Goren, D.D.S.
- Endodontics
- Van Nuys, CA
National Provider Identifier
1174763551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 53907
- Practice address
- 14515 1/2 Victory Blvd
Van Nuys, CA 91411-1619 - Phone
- (818) 902-9999
- Fax
- (818) 902-9393
- NPI assigned
- Feb 25, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 53907 | CA | Primary |
Addresses
Primary practice location
14515 1/2 Victory Blvd
Van Nuys, CA 91411-1619
Mailing address
14515 1/2 Victory Blvd
Van Nuys, CA 91411-1619
Phone (818) 902-9999
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281052800000",
"number": "1174763551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14515 1/2 VICTORY BLVD",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914111619",
"telephone_number": "818-902-9999",
"fax_number": "818-902-9393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14515 1/2 VICTORY BLVD",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914111619",
"telephone_number": "818-902-9999",
"fax_number": "818-902-9393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOREN",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-02-25",
"last_updated": "2010-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "53907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.