Active NPI
Alexander Cristian Gavrila, DDS
- Prosthodontics
- Long Beach, CA
National Provider Identifier
1457640757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 58128
- Practice address
- 4200 Lakewood Blvd
Long Beach, CA 90808 - Phone
- (562) 421-8446
- NPI assigned
- Apr 7, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 58128 | CA | |
| Prosthodontics | 1223P0700X | 58128 | CA | Primary |
Addresses
Primary practice location
4200 Lakewood Blvd
Long Beach, CA 90808
Mailing address
23579 Castlerock
Mission Viejo, CA 92692
Phone (949) 274-5384
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58128 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302134400000",
"number": "1457640757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23579 CASTLEROCK",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "92692",
"telephone_number": "949-274-5384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 LAKEWOOD BLVD",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90808",
"telephone_number": "562-421-8446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAVRILA",
"first_name": "ALEXANDER",
"middle_name": "CRISTIAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-07",
"last_updated": "2011-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "58128",
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "CA",
"license": "58128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.