Inna Kagan D.D.S. a Professional Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

43984 Issued in CA

Legal business name

INNA KAGAN D.D.S. A PROFESSIONAL DENTAL CORPORATION

Practice address

17720 Sherman Way
Reseda, CA 91335-3317

Phone

(818) 705-0111

NPI assigned

Jul 31, 2006

Last updated

Sep 14, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Inna Kagan, D.D.S.NPI 1033308580

Title

President of Corporation

Phone

(818) 705-0111

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Inna Kagan, DDS

  • Dentist
  • Reseda, CA
  • NPI 1033308580
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347580800000",
    "number": "1366457731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17720 SHERMAN WAY",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913353317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17720 SHERMAN WAY",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913353317",
            "telephone_number": "818-705-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNA KAGAN D.D.S. A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2012-09-14",
        "status": "A",
        "authorized_official_last_name": "KAGAN",
        "authorized_official_first_name": "INNA",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "818-705-0111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B43984-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Imperial Home Health Services Inc
• Inception Sleep Center, Inc.
• Independence Community Treatment Clinic
• Ingomar Congregate Living Health Facility
• Ingomar Home
• Inner Child Therapy Corp
• Innovative Diagnostic Imaging Services Inc
• International Healthcare Products, Inc.
• Iraj Borna D.D.S Inc
• Amy Istrin

• General Practice Dentistry in Reseda, CA
• Providers in Reseda, 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 Sep 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.