Fundaminsky Oral Facial DDS Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

FUNDAMINSKY ORAL FACIAL DDS INC

Practice address

9615 Brighton Way Ste 216
Beverly Hills, CA 90210-5118

Phone

(310) 278-0814

NPI assigned

Jan 30, 2023

Last updated

Jan 30, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gennady M Fundaminsky, MD, DDSNPI 1295956357

Title

President

Phone

(310) 801-1296

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Gennady M Fundaminsky, D.D.S

  • Oral and Maxillofacial Surgery (Dentist)
  • Beverly Hills, CA
  • NPI 1295956357
  NPD Authorized official

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1629784046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 BRIGHTON WAY STE 216",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9615 BRIGHTON WAY STE 216",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105118",
            "telephone_number": "310-278-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNDAMINSKY ORAL FACIAL DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-28",
        "status": "A",
        "authorized_official_last_name": "FUNDAMINSKY",
        "authorized_official_first_name": "GENNADY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-801-1296",
        "authorized_official_credential": "MD, DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nelson M Fuentebella, PA-C
• Lucian Fulger
• Nicholas S Fuller, MD
• Functional Restoration Medical Center, Inc, (Beverly Hills 3T Imaging & Research Center)
• Functional Restoration Medical Center, Inc, (Roxbury Pet- CT Imaging)
• Gennady M Fundaminsky, D.D.S
• Kristi Mari Funk, M.D.
• Erich Nathan Funke, PT, DPT
• Robert Furse, MFT
• Isabelle Sophie Futsi, LMFT

• Dental Clinic/Center in Beverly Hills, CA
• Providers in Beverly Hills, 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 Jan 30, 2023; 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.