Bezad Dental Group Professional Corporation

Primary specialty

DentistTaxonomy code 122300000X

License

54696 Issued in CA

Legal business name

BEZAD DENTAL GROUP PROFESSIONAL CORPORATION

Practice address

5620 Wilbur Ave
Suite 310
Tarzana, CA 91356-1351

Phone

(323) 886-3368

NPI assigned

Mar 14, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Patricia Bezad, DMD

Title

Owner

Phone

(323) 886-3368

Specialties & licenses 1

Addresses

Other names 1

• Elite Dental & Implant Center Doing business as

Locations

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1194266841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 WILBUR AVE",
            "address_2": "SUITE 310",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913561351",
            "telephone_number": "323-886-3368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 WILBUR AVE",
            "address_2": "SUITE 310",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913561351",
            "telephone_number": "323-886-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEZAD DENTAL GROUP PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-14",
        "last_updated": "2017-03-14",
        "status": "A",
        "authorized_official_last_name": "BEZAD",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-886-3368",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "54696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Dental & Implant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.