Individual provider Active NPI

Ivan L. Lapidus, D.D.S.

  • Periodontics
  • Los Angeles, CA
National Provider Identifier
1790791739
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
28593 Issued in CA
Practice address
1964 Westwood Blvd
Suite 200
Los Angeles, CA 90025-4651
Phone
(310) 446-4867
Fax
(310) 446-4715
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 28593 CA Primary

Addresses

Primary practice location

1964 Westwood Blvd
Suite 200
Los Angeles, CA 90025-4651

Mailing address

1964 Westwood Blvd
Suite 200
Los Angeles, CA 90025-4651
Phone (310) 446-4867

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
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Nov 15, 2016 through Nov 15, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28593CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Los Angeles PastSince Jun 1, 2019 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790791739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1964 WESTWOOD BLVD",
            "address_2": "SUITE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254651",
            "telephone_number": "310-446-4867",
            "fax_number": "310-446-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1964 WESTWOOD BLVD",
            "address_2": "SUITE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254651",
            "telephone_number": "310-446-4867",
            "fax_number": "310-446-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAPIDUS",
        "first_name": "IVAN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "28593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.