Gennady M Fundaminsky, D.D.S

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

26062 Issued in CA

Practice address

9615 Brighton Way
216
Beverly Hills, CA 90210

Phone

(310) 278-0814

Fax

(310) 278-3487

NPI assigned

May 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Gennady M Fundaminsky Professional name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fundaminsky Oral Facial DDS Inc

  • Dental Clinic/Center
  • Beverly Hills, CA
  • NPI 1629784046
  NPD Authorized official

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674864000000",
    "number": "1295956357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 BRIGHTON WAY",
            "address_2": "216",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90210",
            "telephone_number": "310-278-0814",
            "fax_number": "310-278-3487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9615 BRIGHTON WAY",
            "address_2": "216",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90210",
            "telephone_number": "310-278-0814",
            "fax_number": "310-278-3487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNDAMINSKY",
        "first_name": "GENNADY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2023-01-28",
        "certification_date": "2023-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "26062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENNADY",
            "last_name": "FUNDAMINSKY",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "D.D.S",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lucian Fulger
• Nicholas S Fuller, MD
• Functional Restoration Medical Center, Inc,
• Functional Restoration Medical Center, Inc,
• Fundaminsky Oral Facial DDS Inc
• Kristi Mari Funk, M.D.
• Erich Nathan Funke, PT, DPT
• Robert Furse, MFT
• Isabelle Sophie Futsi, LMFT
• Future Health Physician Services P.C

• Oral and Maxillofacial Surgery (Dentist) in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.