Individual provider Active NPI

Susan Borzou, DDS

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1275415671
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
111984 Issued in CA
Practice address
530 E Washington Blvd
Los Angeles, CA 90015-3723
Phone
(213) 222-2990
NPI assigned
Jul 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 111984 CA Primary

Addresses

Primary practice location

530 E Washington Blvd
Los Angeles, CA 90015-3723

Mailing address

1500 Granville Ave Apt 431
Los Angeles, CA 90025-6892
Phone (206) 887-4854

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

LicenseStateTypeSpecialty
111984CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1753315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1275415671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 GRANVILLE AVE APT 431",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256892",
            "telephone_number": "206-887-4854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 E WASHINGTON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153723",
            "telephone_number": "213-222-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORZOU",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "111984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 24, 2025; 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.