Dmitriy Ivanov, DDS Dental Corp

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

DMITRIY IVANOV, DDS DENTAL CORP

Doing business as

Precision Periodontal and Implant Center Dental Corporation

Practice address

390 N Pacific Coast Hwy Ste 1070
El Segundo, CA 90245-4483

Phone

(310) 708-3938

NPI assigned

Jul 31, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Dmitriy V Ivanov, DDSNPI 1891142055

Title

Owner

Phone

(310) 926-8985

Specialties & licenses 1

Addresses

Other names 1

• Precision Periodontal and Implant Center Dental Corporation Doing business as

Locations

Practitioners 1

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

• Dmitriy Ivanov, DDS

  • Periodontics
  • Los Angeles, CA
  • NPI 1891142055
  NPD Authorized official

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

{
    "created_epoch": "1753920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753920000000",
    "number": "1619850088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 MATHEWS AVE UNIT A",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902785503",
            "telephone_number": "310-926-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N PACIFIC COAST HWY STE 1070",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454483",
            "telephone_number": "310-708-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DMITRIY IVANOV, DDS DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-31",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-30",
        "status": "A",
        "authorized_official_last_name": "IVANOV",
        "authorized_official_first_name": "DMITRIY",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-926-8985",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Precision Periodontal and Implant Center Dental Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Disler
• Imani Dixon
• Lena Addy Dixon
• Mamadou Djiallo
• Abigail Djongakoy
• Alvin DO
• Anh DO
• Benjamin DO
• Britney Doan
• Daryl Doan

• Periodontics in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; 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.