Active NPI
Boris Grigorovich, DDS
- Dentist
- Simi Valley, CA
National Provider Identifier
1679701106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 49325
- Practice address
- 2345 Erringer Rd
Suite 220
Simi Valley, CA 93065-2235 - Phone
- (805) 583-5589
- NPI assigned
- Jun 23, 2009
- 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 | 49325 | CA | Primary |
Addresses
Primary practice location
2345 Erringer Rd
Suite 220
Simi Valley, CA 93065-2235
Mailing address
13302 Nantucket PL
Bakersfield, CA 93314-6547
Phone (818) 800-4464
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 |
|---|---|---|---|
| 49325 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245715200000",
"number": "1679701106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13302 NANTUCKET PL",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933146547",
"telephone_number": "818-800-4464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2345 ERRINGER RD",
"address_2": "SUITE 220",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930652235",
"telephone_number": "805-583-5589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIGOROVICH",
"first_name": "BORIS",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-23",
"last_updated": "2009-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "49325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Simi Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.