Organization Active NPI

Stephen Weisberg DDS Inc

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1679756464
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
CA 017210 Issued in CA
Legal business name
STEPHEN WEISBERG DDS INC
Practice address
11600 Wilshire Blvd
Suite 520
Los Angeles, CA 90025-5781
Phone
(310) 444-9900
Fax
(310) 444-9928
NPI assigned
Dec 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

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

Authorized official

Name
Dr. Stephen Weisberg, DDS
Title
Owner
Phone
(310) 444-9900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X CA 017210 CA Primary

Addresses

Primary practice location

11600 Wilshire Blvd
Suite 520
Los Angeles, CA 90025-5781

Mailing address

11600 Wilshire Blvd
Suite 520
Los Angeles, CA 90025-5781
Phone (310) 444-9900

National Provider Directory

National Provider Directory

Locations

11600 Wilshire Blvd
Ste 520
Los Angeles, CA 90025
Phone (310) 444-9900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197590400000",
    "number": "1679756464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 WILSHIRE BLVD",
            "address_2": "SUITE 520",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255781",
            "telephone_number": "310-444-9900",
            "fax_number": "310-444-9928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 WILSHIRE BLVD",
            "address_2": "SUITE 520",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255781",
            "telephone_number": "310-444-9900",
            "fax_number": "310-444-9928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN WEISBERG DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2007-12-14",
        "status": "A",
        "authorized_official_last_name": "WEISBERG",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-444-9900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "CA 017210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; 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.