Active NPI
Bita Davoodian, D.D.S.
- Dentist
- Redondo Beach, CA
National Provider Identifier
1346520053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 60768
- Practice address
- 1959 Kingsdale Ave Ste 202
Redondo Beach, CA 90278-3417 - Phone
- (310) 793-1000
- NPI assigned
- Aug 25, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 60768 | CA | Primary |
Addresses
Primary practice location
1959 Kingsdale Ave Ste 202
Redondo Beach, CA 90278-3417
Mailing address
PO Box 146
Redondo Beach, CA 90277-0146
Phone (310) 372-6600
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350432000000",
"number": "1346520053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 146",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902770146",
"telephone_number": "310-372-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1959 KINGSDALE AVE STE 202",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902783417",
"telephone_number": "310-793-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVOODIAN",
"first_name": "BITA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-25",
"last_updated": "2012-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "60768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redondo Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.