Individual provider Active NPI

Moshe Eizdi, DDS

  • Dentist
  • West Covina, CA
National Provider Identifier
1457729659
Registry record updated Sep 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
65070 Issued in CA
Practice address
2233 E Garvey Ave N
West Covina, CA 91791-1500
Phone
(626) 966-3033
NPI assigned
Sep 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 65070 CA Primary

Addresses

Primary practice location

2233 E Garvey Ave N
West Covina, CA 91791-1500

Mailing address

2233 E Garvey Ave N
West Covina, CA 91791-1500
Phone (626) 966-3033

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

LicenseStateTypeSpecialty
65070CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Eizdi DDS Inc CurrentSince Mar 24, 2024 Accepting new patients

Locations

2511 Artesia Blvd
Redondo Beach, CA 90278
Phone (310) 542-6988

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441324800000",
    "number": "1457729659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 E GARVEY AVE N",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911500",
            "telephone_number": "626-966-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 E GARVEY AVE N",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911500",
            "telephone_number": "626-966-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIZDI",
        "first_name": "MOSHE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-04",
        "last_updated": "2015-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "65070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; 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.