Active NPI
Stewart R Balikov, DDS
- Dentist
- Beverly Hills, CA
National Provider Identifier
1679539852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 31199
- Practice address
- 8641 Wilshire Blvd
Beverly Hills, CA 90211 - Phone
- (818) 642-8052
- NPI assigned
- Apr 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 31199 | CA | Primary |
Addresses
Primary practice location
8641 Wilshire Blvd
Beverly Hills, CA 90211
Mailing address
4607 Lakeview Canyon Rd Ste 118
Westlake Village, CA 91361-4028
Phone (181) 864-2805
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31199 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600214400000",
"number": "1679539852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4607 LAKEVIEW CANYON RD STE 118",
"city": "WESTLAKE VILLAGE",
"state": "CA",
"postal_code": "913614028",
"telephone_number": "181-864-2805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8641 WILSHIRE BLVD",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "90211",
"telephone_number": "818-642-8052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALIKOV",
"first_name": "STEWART",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-25",
"last_updated": "2020-09-16",
"certification_date": "2020-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "31199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.