West Los Angeles Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

WEST LOS ANGELES DENTISTRY

Practice address

11870 Santa Monica Blvd
Suite 212
Los Angeles, CA 90025-2281

Phone

(310) 207-4900

Fax

(310) 207-8358

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Robert Hazany, DDSNPI 1669740429

Title

Dentist Partner

Phone

(310) 207-4900

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

6TH Street Family Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• 6TH Street Family Dental Group

  • Dentist
  • Los Angeles, CA
  • NPI 1194879627
  NPD tax ID

Locations

Practitioners 3

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

• Robert Hazany, DDS

  • Dentist
  • Canoga Park, CA
  • NPI 1669740429
  Medicare reassignment NPD Authorized official
• Minoo Beroukhim, DDS

  • Dentist
  • Los Angeles, CA
  • NPI 1013337575
  NPD (past)
• Soheil Refoua

  • Dentist
  • South Gate, CA
  • NPI 1205651106
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300147200000",
    "number": "1508923707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11870 SANTA MONICA BLVD",
            "address_2": "SUITE 212",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252281",
            "telephone_number": "310-207-4900",
            "fax_number": "310-207-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11870 SANTA MONICA BLVD",
            "address_2": "SUITE 212",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252281",
            "telephone_number": "310-207-4900",
            "fax_number": "310-207-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST LOS ANGELES DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2011-03-15",
        "status": "A",
        "authorized_official_last_name": "HAZANY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DENTIST PARTNER",
        "authorized_official_telephone_number": "310-207-4900",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• West la Ms Inc.
• West la Physical Medicine Inc.
• West la Spine ASC LLC
• West la Surgery Center, LLC
• West la Therapist Corp
• West Los Angeles Hand Therapy Inc
• West Los Angeles Urgent Care
• West Los Angeles VA
• West Los Angeles VA Medical Center
• West Los Angeles Vamc

• Dental Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; 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.