Jonathan David Pivo, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

53645 Issued in CA

Practice address

12849 Magnolia Blvd
Valley Village, CA 91607-2356

Phone

(818) 766-3777

NPI assigned

Apr 18, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1649496282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12849 MAGNOLIA BLVD",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916072356",
            "telephone_number": "818-766-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12849 MAGNOLIA BLVD",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916072356",
            "telephone_number": "818-766-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIVO",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sierra Marie Phillips
• Xylia Chilali-Cres'Stal Phillips
• Physical Therapy for Specialty Care
• Hagop Jack Pilafdzhyan
• Pink Moon Lactation and OT, LLC
• Natalia Plotkin
• Petros Pogosyan
• David Polushkin, DDS
• Michelle Colleen Pringle, MFTI
• Priority Hospice Care Inc.

• General Practice Dentistry in Valley Village, CA
• Providers in Valley Village, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; 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.