Active NPI
Aleksandar Jovanovic, DDS, MS
- Periodontics
- Los Angeles, CA
National Provider Identifier
1568695922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- D6222
- Practice address
- 12217 W Pico Blvd
Los Angeles, CA 90064-1134 - Phone
- (310) 820-9641
- Fax
- (310) 207-9025
- NPI assigned
- Sep 1, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | D6222 | AZ | Primary |
Addresses
Primary practice location
12217 W Pico Blvd
Los Angeles, CA 90064-1134
Mailing address
12217 W Pico Blvd
Los Angeles, CA 90064-1134
Phone (310) 820-9641
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D6222 | AZ | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gide Dental Implant Center | Periodontics | Current | Accepting new patients |
Locations
12217 W Pico Blvd
Los Angeles, CA 90064
Phone (310) 820-9641
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": "1251763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771804800000",
"number": "1568695922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12217 W PICO BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900641134",
"telephone_number": "310-820-9641",
"fax_number": "310-207-9025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12217 W PICO BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900641134",
"telephone_number": "310-820-9641",
"fax_number": "310-207-9025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOVANOVIC",
"first_name": "ALEKSANDAR",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-01",
"last_updated": "2026-02-23",
"certification_date": "2026-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "AZ",
"license": "D6222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.