NPIMap

Organization Active NPI

Pessah Dental Corporation

Doing business as Downey Modern Dentistry Dental Group

  • Dentist
  • Downey, CA
National Provider Identifier
1619528064
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PESSAH DENTAL CORPORATION
Doing business as
Downey Modern Dentistry Dental Group
Practice address
12214 Lakewood Blvd Ste 102
Downey, CA 90242-2663
Phone
(562) 273-2050
Fax
(562) 247-9788
NPI assigned
Sep 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Authorized official

Name
Ariella Pessah, DDS
Title
GP/Owner
Phone
(562) 273-2050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

12214 Lakewood Blvd Ste 102
Downey, CA 90242-2663

Mailing address

PO Box 920050
Dallas, TX 75392-0050
Phone (714) 845-8500

Other names 1

  • Downey Modern Dentistry Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

12214 Lakewood Blvd
Ste 102
Downey, CA 90242
Phone (562) 273-2050

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": "1569456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659657600000",
    "number": "1619528064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12214 LAKEWOOD BLVD STE 102",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902422663",
            "telephone_number": "562-273-2050",
            "fax_number": "562-247-9788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PESSAH DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-26",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "PESSAH",
        "authorized_official_first_name": "ARIELLA",
        "authorized_official_title_or_position": "GP/OWNER",
        "authorized_official_telephone_number": "562-273-2050",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Downey Modern Dentistry Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Downey Modern Dentistry Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 5, 2022; 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.