Sophia Rozov DDS, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

45820 Issued in CA

Legal business name

SOPHIA ROZOV DDS, INC

Doing business as

Smile Avenue Dental Group

Practice address

8543 Rosemead Blvd
# D
Pico Rivera, CA 90660-5427

Phone

(562) 904-0400

Fax

(562) 904-1803

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Sophia Rozov, DDSNPI 1376688663

Title

Ceo

Phone

(562) 904-0400

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Smile Avenue Dental Group Doing business as

Tax ID family

Smile Avenue Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sophia Rozov DDS, Inc

  • General Practice Dentistry
  • Tarzana, CA
  • NPI 1184749392
  NPD tax ID

Locations

Practitioners 1

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

• Sophia Rozov, DDS

  • General Practice Dentistry
  • Tarzana, CA
  • NPI 1376688663
  NPD (past) Authorized official

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453420800000",
    "number": "1346365657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5640 ETIWANDA AVE",
            "address_2": "# 5",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913562700",
            "telephone_number": "562-904-0400",
            "fax_number": "562-904-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8543 ROSEMEAD BLVD",
            "address_2": "# D",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906605427",
            "telephone_number": "562-904-0400",
            "fax_number": "562-904-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOPHIA ROZOV DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2016-01-22",
        "status": "A",
        "authorized_official_last_name": "ROZOV",
        "authorized_official_first_name": "SOPHIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-904-0400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA-DENTAL",
            "identifier": "01-45820",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "G93356-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Avenue Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maria Del Carmen Solis, L.C.S.W.
• Nicolas Jaymie Solomon, ATC
• David Solorio
• Keith Aaron J Somsanith, D.O.
• Kang Son, L.AC
• Sorour D.M.D, P.C
• Stephanie Andrea Sorto
• Cynthia Soto
• Helena P. Soto, B.A
• Samuel Sousa

• General Practice Dentistry in Pico Rivera, CA
• Providers in Pico Rivera, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; 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.