Victoria Olshansky D D S Inc
Organization Active NPI Dentist · W Hollywood, CA
NPI 1194910588 · NPPES record last updated Jun 22, 2021
Key facts
- NPI
- 1194910588
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 46315 (CA)
- Legal business name
- VICTORIA OLSHANSKY D D S INC
- Practice address
- 1136 N Fairfax Ave
W Hollywood, CA 90046-5307 - Phone
- (323) 650-6936
- NPI assigned
- Sep 10, 2007
- Organization subpart
- No
Authorized official
- Name
- Victoria Olshansky
- Title
- Doctor
- Phone
- (323) 650-6936
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210624003183 | CA | Part B Supplier - Clinic/Group Practice | 4486055654 |
Receives reassigned benefits from 1 practitioner Practice locations: West Hollywood, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 46315 | CA | Yes |
Addresses
Primary practice location
1136 N Fairfax Ave
W Hollywood, CA 90046-5307
Mailing address
1136 N Fairfax Ave
W Hollywood, CA 90046-5307
Other providers in W Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.