Active NPI
Mark S Treystman, DDS
- General Practice Dentistry
- Los Angeles, CA
National Provider Identifier
1316131980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 45416
- Practice address
- 8158 Beverly Blvd
Los Angeles, CA 90048-4513 - Phone
- (323) 653-5484
- Fax
- (323) 653-5485
- NPI assigned
- Aug 28, 2007
- Last updated
- Aug 28, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 45416 | CA | Primary |
Addresses
Primary practice location
8158 Beverly Blvd
Los Angeles, CA 90048-4513
Mailing address
8158 Beverly Blvd
Los Angeles, CA 90048-4513
Phone (323) 653-5484
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D45416 | Medicaid | CA | |
| G93729-01 | Medicaid | CA | |
| G93731-01 | Medicaid | CA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45416 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark Treystman DDS Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188259200000",
"number": "1316131980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8158 BEVERLY BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900484513",
"telephone_number": "323-653-5484",
"fax_number": "323-653-5485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8158 BEVERLY BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900484513",
"telephone_number": "323-653-5484",
"fax_number": "323-653-5485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TREYSTMAN",
"first_name": "MARK",
"middle_name": "S",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-28",
"last_updated": "2007-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "45416",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D45416",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G93729-01",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G93731-01",
"state": "CA"
}
],
"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 Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.