NPIMap

Organization Active NPI

I Zak DDS Prof Dental Corp

  • Dentist
  • Downey, CA
National Provider Identifier
1588901979
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
38238 Issued in CA
Legal business name
I ZAK DDS PROF DENTAL CORP
Practice address
10501 Lakewood Blvd
Ste a & B
Downey, CA 90241-2709
Phone
(562) 862-2341
Fax
(562) 861-8350
NPI assigned
Jan 7, 2013
Last updated
Apr 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

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

Authorized official

Name
Dr. Ilya Zak, DDSNPI 1023165255
Title
Owner, Dentist
Phone
(310) 706-5273

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 38238 CA Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 26453 CA
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 61574 CA
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 46372 CA
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 55241 CA
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 48766 CA
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X 20673 CA
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 60315 CA
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 48198 CA
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 57513C CA

Addresses

Primary practice location

10501 Lakewood Blvd
Ste a & B
Downey, CA 90241-2709

Mailing address

10501 Lakewood Blvd
Ste a & B
Downey, CA 90241-2709
Phone (562) 862-2341

Other identifiers 1

IdentifierTypeStateIssuer
38238OtherCADENTAL LICENCE NUMBER

Other names 1

  • Dr. Zak Downey Dental Care Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231220003181 CA Part B Supplier - Clinic/Group Practice 9133579808 Receives reassigned benefits from 20 practitioners
11 other NPIs on this enrollment
Practice locations: Temecula, CA; Whittier, CA; Ventura, CA; Valencia, CA; Simi Valley, CA; Santa Barbara, CA; San Diego, CA; Long Beach, CA…

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
I Zak DDS Prof Dental Corp14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

10501 Lakewood Blvd
#A
Downey, CA 90241
Phone (562) 862-2341

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1588901979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10501 LAKEWOOD BLVD",
            "address_2": "STE A & B",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902412709",
            "telephone_number": "562-862-2341",
            "fax_number": "562-861-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10501 LAKEWOOD BLVD",
            "address_2": "STE A & B",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902412709",
            "telephone_number": "562-862-2341",
            "fax_number": "562-861-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I ZAK DDS PROF DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-07",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "ZAK",
        "authorized_official_first_name": "ILYA",
        "authorized_official_title_or_position": "OWNER, DENTIST",
        "authorized_official_telephone_number": "310-706-5273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "38238",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "26453",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "61574",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "46372",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "55241",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "48766",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "20673",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "60315",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "48198",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "57513C",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENCE NUMBER",
            "identifier": "38238",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Zak Downey Dental Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Downey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; 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.