Individual provider Active NPI

Rogelio M Garcia-Jasny, D.D.S

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1689012486
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61672 Issued in CA
Practice address
10700 Santa Monica Blvd Ste 140
Los Angeles, CA 90025-6386
Phone
(310) 470-6121
NPI assigned
Jun 13, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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 61672 CA Primary

Addresses

Primary practice location

10700 Santa Monica Blvd Ste 140
Los Angeles, CA 90025-6386

Mailing address

10700 Santa Monica Blvd Ste 140
Los Angeles, CA 90025-6386
Phone (310) 470-6121

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
I20150820010729 CA Order and Referring Only - DentistPractitioner - Dentist 8022323930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61672CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Dental Services Past Accepting new patients
Pacific Dental Services Past Accepting new patients

Organizations & group practices 2

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": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1689012486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 SANTA MONICA BLVD STE 140",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256386",
            "telephone_number": "310-470-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 SANTA MONICA BLVD STE 140",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256386",
            "telephone_number": "310-470-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA-JASNY",
        "first_name": "ROGELIO",
        "middle_name": "M",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-13",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.