NPIMap

Organization Active NPI

Glendale Surgical Associates, LP

Doing business as Pacific Coast OMS

  • Oral and Maxillofacial Surgery (Dentist)
  • Mission Hills, CA
National Provider Identifier
1497003685
Registry record updated Aug 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
OMS94 Issued in CA
Legal business name
GLENDALE SURGICAL ASSOCIATES, LP
Doing business as
Pacific Coast OMS
Practice address
11550 Indian Hills Rd Ste 270
Mission Hills, CA 91345-1244
Phone
(818) 365-5636
Fax
(818) 365-5639
NPI assigned
Aug 21, 2012
Organization subpart
Yes
Parent organization
GLENDALE SURGICAL ASSOCIATES, LPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 21, 2012

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

Authorized official

Name
Dianne Lafaurie
Title
Office Manager
Phone
(818) 241-4217

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X OMS94 CA Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 21413 CA
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X OMS71 CA
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 37945 CA

Addresses

Primary practice location

11550 Indian Hills Rd Ste 270
Mission Hills, CA 91345-1244

Mailing address

11550 Indian Hills Rd Ste 270
Mission Hills, CA 91345-1244
Phone (818) 365-5636

Other names 1

  • Pacific Coast OMS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Glendale Surgical Associates LP4 organizations share this tax ID, including this one
Part of
Glendale Surgical Associates LP

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11550 Indian Hills Rd
Ste 270
Mission Hills, CA 91345
Phone (818) 365-5636

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345507200000",
    "number": "1497003685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11550 INDIAN HILLS RD STE 270",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451244",
            "telephone_number": "818-365-5636",
            "fax_number": "818-365-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11550 INDIAN HILLS RD STE 270",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451244",
            "telephone_number": "818-365-5636",
            "fax_number": "818-365-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE SURGICAL ASSOCIATES, LP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GLENDALE SURGICAL ASSOCIATES, LP",
        "enumeration_date": "2012-08-21",
        "last_updated": "2012-08-21",
        "status": "A",
        "authorized_official_last_name": "LAFAURIE",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "818-241-4217"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "OMS94",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "21413",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "OMS71",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "37945",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Coast OMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mission Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.

Verify at the official NPI Registry.