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
- Last updated
- 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 |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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
- Elaine Verchick, M.A. MFT
- Jene Elana Verchick, PSY.D.
- Mariana Vergara, FNP-C
- Vershinin Dental Corporation (Beverly Hills Biodental)
- Grigory Vershinin, DMD
- Tatiana Vershinina, DDS
- Therese Kathryn Vesagas
- Ghazal Vessal, PHARMACIST
- Vicki Rapaport, M.D., a Professional Corporation (Rapaport Dermatology of Beverly Hills)
- Victor Gura MD, Inc (Medipace Medical Group)
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.