Individual provider Active NPI

Elena Grin, DA

  • Dental Assistant
  • Torrance, CA
National Provider Identifier
1285004937
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
33289 Issued in CA
Practice address
4305 Torrance Blvd Ste 505
Torrance, CA 90503-4496
Phone
(310) 933-6650
Fax
(855) 808-4551
NPI assigned
Oct 6, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X 33289 CA Primary

Addresses

Primary practice location

4305 Torrance Blvd Ste 505
Torrance, CA 90503-4496

Mailing address

4305 Torrance Blvd Ste 505
Torrance, CA 90503-4496
Phone (310) 933-6650

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
33289CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1285004937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 TORRANCE BLVD STE 505",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034496",
            "telephone_number": "310-933-6650",
            "fax_number": "855-808-4551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 TORRANCE BLVD STE 505",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034496",
            "telephone_number": "310-933-6650",
            "fax_number": "855-808-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIN",
        "first_name": "ELENA",
        "credential": "DA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "CA",
            "license": "33289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; 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.