Edward Rabinovich, DDS, Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

40712 Issued in CA

Legal business name

EDWARD RABINOVICH, DDS, INC.

Practice address

3855 Avocado Blvd.
Ste. 250
La Mesa, CA 91941

Phone

(619) 660-9800

Fax

(619) 660-8628

NPI assigned

Jun 8, 2017

Organization subpart

No

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

Authorized official

Name

Edward RabinovichNPI 1154464139

Title

President

Phone

(619) 660-9800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Edward Rabinovich DDS Former legal business name

Locations

Practitioners 1

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

• Edward Rabinovich, D.D.S.

  • General Practice Dentistry
  • La Mesa, CA
  • NPI 1154464139
  NPD (past) Authorized official

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1801325238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3855 AVOCADO BLVD STE 250",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919417382",
            "telephone_number": "619-660-9800",
            "fax_number": "619-660-8628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 AVOCADO BLVD.",
            "address_2": "STE. 250",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91941",
            "telephone_number": "619-660-9800",
            "fax_number": "619-660-8628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD RABINOVICH, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "RABINOVICH",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-660-9800"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "40712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1154464139",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edward Rabinovich DDS",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Edward Rabinovich DDS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Dentist in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.