NPIMap

Organization Active NPI

Dentalville

  • Dentist
  • Panorama City, CA
National Provider Identifier
1639375488
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
B26405-03 Issued in CA
Legal business name
DENTALVILLE
Practice address
7864 Van Nuys Blvd
Panorama City, CA 91402-6069
Phone
(818) 989-2400
Fax
(818) 989-2457
NPI assigned
Jun 26, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Leonid Glosman Sr., DDSNPI 1053420216
Title
Owner
Phone
(323) 266-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X B26405-03 CA Primary

Addresses

Primary practice location

7864 Van Nuys Blvd
Panorama City, CA 91402-6069

Mailing address

7864 Van Nuys Blvd
Panorama City, CA 91402-6069
Phone (818) 989-2400

National Provider Directory

National Provider Directory
Tax ID family
Dentalville4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

7864 Van Nuys Blvd
Van Nuys, CA 91402
Phone (818) 989-2400

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639375488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7864 VAN NUYS BLVD",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914026069",
            "telephone_number": "818-989-2400",
            "fax_number": "818-989-2457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7864 VAN NUYS BLVD",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914026069",
            "telephone_number": "818-989-2400",
            "fax_number": "818-989-2457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTALVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GLOSMAN",
        "authorized_official_first_name": "LEONID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-266-1000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "B26405-03",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panorama City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.