Individual provider Active NPI

Stewart D Flachner, DDS

  • Dentist
  • Palos Verdes, CA
National Provider Identifier
1215023189
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
28687 Issued in CA
Practice address
6704 Los Verdes Dr
Palos Verdes, CA 90275
Phone
(310) 283-1583
NPI assigned
Oct 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 28687 CA Primary

Addresses

Primary practice location

6704 Los Verdes Dr
Palos Verdes, CA 90275

Mailing address

6704 Los Verdes Dr
Palos Verdes, CA 90275
Phone (310) 283-1583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151106001866 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7214247030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28687CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215023189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6704 LOS VERDES DR",
            "city": "PALOS VERDES",
            "state": "CA",
            "postal_code": "90275",
            "telephone_number": "310-283-1583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6704 LOS VERDES DR",
            "city": "PALOS VERDES",
            "state": "CA",
            "postal_code": "90275",
            "telephone_number": "310-283-1583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLACHNER",
        "first_name": "STEWART",
        "middle_name": "D",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "28687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Verdes, CA

Sources for this page

Verify at the official NPI Registry.