NPIMap

Organization Active NPI

Bina, Korouri, Sage Dental Corporation

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1255656823
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BINA, KOROURI, SAGE DENTAL CORPORATION
Practice address
3000 Whittier Blvd
Los Angeles, CA 90023-1637
Phone
(310) 927-5848
NPI assigned
Apr 7, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Authorized official

Name
Dr. Pedram Bina, DDSNPI 1134300866
Title
Ceo
Phone
(310) 433-2722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3000 Whittier Blvd
Los Angeles, CA 90023-1637

Mailing address

3000 Whittier Blvd
Los Angeles, CA 90023-1637
Phone (310) 927-5848

Other names 1

  • PHD Dental Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140610002395 CA Part B Supplier - Clinic/Group Practice 3779707849 Receives reassigned benefits from 3 practitioners
3 other NPIs on this enrollment
Practice locations: Inglewood, CA; Pico Rivera, CA; Lynwood, CA; Los Angeles, CA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Bina Korouri Sage Dental Corporation6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686268800000",
    "number": "1255656823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900231637",
            "telephone_number": "310-927-5848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900231637",
            "telephone_number": "310-927-5848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BINA, KOROURI, SAGE DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-07",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A",
        "authorized_official_last_name": "BINA",
        "authorized_official_first_name": "PEDRAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-433-2722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHD Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.