Susanna Gukasov DDS Professional Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SUSANNA GUKASOV DDS PROFESSIONAL CORPORATION

Practice address

19520 Nordhoff St Ste 17
Northridge, CA 91324-2444

Phone

(818) 701-9400

NPI assigned

Dec 29, 2023

Organization subpart

No

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

Authorized official

Name

Susanna Gukasov, DDSNPI 1679919997

Title

Dentist

Phone

(323) 369-2493

Specialties & licenses 1

Addresses

Practitioners 1

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

• Susanna Gukasov, D.D.S.

  • General Practice Dentistry
  • Northridge, CA
  • NPI 1679919997
  NPD Authorized official

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

{
    "created_epoch": "1703808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1285403436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18746 MAPLEWOOD LN",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913263927",
            "telephone_number": "323-369-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19520 NORDHOFF ST STE 17",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913242444",
            "telephone_number": "818-701-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSANNA GUKASOV DDS PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-29",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "GUKASOV",
        "authorized_official_first_name": "SUSANNA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "323-369-2493",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Northridge, CA
• Providers in Northridge, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.