Active NPI
Kumzoo Wohn, D.D.S.
- Dentist
- Los Angeles, CA
National Provider Identifier
1770659716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 43409
- Practice address
- 4165 Beverly Blvd
Los Angeles, CA 90004-4418 - Phone
- (323) 662-2141
- NPI assigned
- Nov 28, 2006
- Sex
- Female
- 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 | 43409 | CA | Primary |
Addresses
Primary practice location
4165 Beverly Blvd
Los Angeles, CA 90004-4418
Mailing address
10600 Wilkins Ave
#1C
Los Angeles, CA 90024-6078
Phone (310) 475-5122
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150924000960 | CA | Order and Referring Only - Dentist | 8224346226 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- kwohn@direct.westerndental.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770659716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10600 WILKINS AVE",
"address_2": "#1C",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900246078",
"telephone_number": "310-475-5122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4165 BEVERLY BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900044418",
"telephone_number": "323-662-2141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOHN",
"first_name": "KUMZOO",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "43409",
"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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.