Anatoly Vaisman D.D.S., Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

43259 Issued in CA

Legal business name

ANATOLY VAISMAN D.D.S., INC

Practice address

11273 Laurel Canyon Blvd Ste 3
San Fernando, CA 91340-4358

Phone

(818) 365-7191

Fax

(818) 361-7641

NPI assigned

Apr 1, 2009

Organization subpart

Yes

Parent organization

ANATOLY VAISMAN D.D., INCAs reported in NPPES

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

Authorized official

Name

Maria Carlos

Title

Office Manage

Phone

(818) 365-7191

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Anatoly Vaisan DDS Inc

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anatoly Vaisman, DDS

  • Dentist
  • San Fernando, CA
  • NPI 1619025277
  NPD (past)

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238544000000",
    "number": "1235371600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11273 LAUREL CANYON BLVD STE 3",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913404358",
            "telephone_number": "818-365-7191",
            "fax_number": "818-361-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11273 LAUREL CANYON BLVD STE 3",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913404358",
            "telephone_number": "818-365-7191",
            "fax_number": "818-361-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANATOLY VAISMAN D.D.S., INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANATOLY VAISMAN D.D., INC",
        "enumeration_date": "2009-04-01",
        "last_updated": "2009-04-01",
        "status": "A",
        "authorized_official_last_name": "CARLOS",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "OFFICE MANAGE",
        "authorized_official_telephone_number": "818-365-7191"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G93630-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anais Chorbadjian OD, a Professional Corp
• Anari Medical Corp
• Ali Anari, M.D.
• Fatemeh Anari
• Anatoly Vaisan DDS Inc
• Leslie Anaya
• Tiffany Marie Andrade
• Christopher Ang Angara, PHARMD
• Apex Care RX Inc
• Enrique A Araujo, DDS

• General Practice Dentistry in San Fernando, CA
• Providers in San Fernando, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; 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.