Individual provider Active NPI

Dan Diep, DDS

  • Dentist
  • Culver City, CA
National Provider Identifier
1184257891
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
105713 Issued in CA
Practice address
6167 Bristol Pkwy Ste 300
Culver City, CA 90230-6616
Phone
(310) 734-4547
NPI assigned
Feb 20, 2020
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 105713 CA Primary

Addresses

Primary practice location

6167 Bristol Pkwy Ste 300
Culver City, CA 90230-6616

Mailing address

6167 Bristol Pkwy Ste 300
Culver City, CA 90230-6616
Phone (310) 734-4547

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
105713CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ahuja Bristol Dental Inc Dentist CurrentSince Jul 13, 2025 Accepting new patients
Shou Chia Huang DMD Inc PastSince Nov 24, 2024 Accepting new patients
Jennifer T. Nguyen, DMD, Inc. PastSince May 1, 2023 Accepting new patients

Locations

6167 Bristol Pkwy
Ste 300
Los Angeles, CA 90230
Phone (310) 734-4547

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1184257891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6167 BRISTOL PKWY STE 300",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306616",
            "telephone_number": "310-734-4547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6167 BRISTOL PKWY STE 300",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306616",
            "telephone_number": "310-734-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEP",
        "first_name": "DAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-20",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.