Bashar Komoc, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

42317 Issued in CA

Practice address

7151 W 91St St
Los Angeles, CA 90045-3446

Phone

(310) 670-2983

Fax

(310) 670-2983

NPI assigned

Feb 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

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.

• Bashar Komoc DDS, Inc.

  dba American Dental Center

  • General Practice Dentistry
  • Long Beach, CA
  • NPI 1114181260
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1437290897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3318E ANAHEIM ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908044025",
            "telephone_number": "562-986-5570",
            "fax_number": "562-986-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7151 W 91ST ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453446",
            "telephone_number": "310-670-2983",
            "fax_number": "310-670-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMOC",
        "first_name": "BASHAR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abraham Kombajian
• Keiko Komiyama
• Sanath S Kommineni, DDS
• Vivek Kommineni, DPM
• Alexia Komninos, LAC
• David V Kon, M.D.
• Jocelyn Pogue Kon, ACNP
• Philantha Sue-Hwa Kon, M.D., PH.D.
• Zoeann Aiko Maluhia Kon, MPH, MD
• Ndeye Ngone Konate, DO

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, 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 Dec 11, 2015; 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.