Active NPI
Goar Vershinina
- Dentist
- Beverly Hills, CA
National Provider Identifier
1235643115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS100895
- Practice address
- 416 N Bedford Dr Ste 103
Beverly Hills, CA 90210-4308 - Phone
- (818) 585-8023
- NPI assigned
- Nov 29, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DDS100895 | CA | Primary |
Addresses
Primary practice location
416 N Bedford Dr Ste 103
Beverly Hills, CA 90210-4308
Mailing address
1421 Ambassador St Apt 202
Los Angeles, CA 90035-2834
Phone (818) 585-8023
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
| License | State | Type | Specialty |
|---|---|---|---|
| DDS100895 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511913600000",
"number": "1235643115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1421 AMBASSADOR ST APT 202",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900352834",
"telephone_number": "818-585-8023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "416 N BEDFORD DR STE 103",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902104308",
"telephone_number": "818-585-8023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERSHININA",
"first_name": "GOAR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-29",
"last_updated": "2017-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS100895",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.