Individual provider Active NPI

David Vaysleyb, DDS

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1639427404
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61841 Issued in CA
Practice address
10673 W Pico Blvd
Los Angeles, CA 90064-2221
Phone
(310) 963-7066
NPI assigned
Aug 27, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 61841 CA Primary

Addresses

Primary practice location

10673 W Pico Blvd
Los Angeles, CA 90064-2221

Mailing address

10673 W Pico Blvd
Los Angeles, CA 90064-2221
Phone (310) 963-7066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150903002209 CA Practitioner - Oral Surgery 1052627122 Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61841CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
David Vaysleyb DDS Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1639427404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10673 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642221",
            "telephone_number": "310-963-7066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10673 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642221",
            "telephone_number": "310-963-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAYSLEYB",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-27",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.