Active NPI
Barry Dean Weichman, DDS
- Endodontics
- Los Angeles, CA
National Provider Identifier
1689886616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 24191
- Practice address
- 11980 San Vicente Blvd
Suite 507
Los Angeles, CA 90049-5012 - Phone
- (310) 820-0123
- Fax
- (310) 207-3784
- NPI assigned
- May 3, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 24191 | CA | Primary |
Addresses
Primary practice location
11980 San Vicente Blvd
Suite 507
Los Angeles, CA 90049-5012
Mailing address
11980 San Vicente Blvd
Suite 507
Los Angeles, CA 90049-5012
Phone (310) 820-0123
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 19, 2018 through Mar 19, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Jay Grossman & Associates | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Los Angeles, CA
- NPI 1811553324
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689886616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11980 SAN VICENTE BLVD",
"address_2": "SUITE 507",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900495012",
"telephone_number": "310-820-0123",
"fax_number": "310-207-3784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11980 SAN VICENTE BLVD",
"address_2": "SUITE 507",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900495012",
"telephone_number": "310-820-0123",
"fax_number": "310-207-3784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEICHMAN",
"first_name": "BARRY",
"middle_name": "DEAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "24191",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.