Organization Active NPI

Jean-Jacques Elbaz DDS Ms a Prof Dental Corp

  • Periodontics
  • Beverly Hills, CA
National Provider Identifier
1801453121
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
JEAN-JACQUES ELBAZ DDS MS A PROF DENTAL CORP
Practice address
9465 Wilshire Blvd Ste 450
Beverly Hills, CA 90212-2614
Phone
(310) 274-0456
NPI assigned
May 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Authorized official

Name
Maria Rivas
Title
Receptionist
Phone
(310) 274-0456

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X Primary

Addresses

Primary practice location

9465 Wilshire Blvd Ste 450
Beverly Hills, CA 90212-2614

Mailing address

9465 Wilshire Blvd Ste 450
Beverly Hills, CA 90212-2614
Phone (310) 274-0456

National Provider Directory

National Provider Directory

Locations

9465 Wilshire Blvd
Ste 450
Beverly Hills, CA 90212
Phone (310) 274-0456

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627862400000",
    "number": "1801453121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9465 WILSHIRE BLVD STE 450",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902122614",
            "telephone_number": "310-274-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9465 WILSHIRE BLVD STE 450",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902122614",
            "telephone_number": "310-274-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEAN-JACQUES ELBAZ DDS MS A PROF DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-22",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A",
        "authorized_official_last_name": "RIVAS",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "RECEPTIONIST",
        "authorized_official_telephone_number": "310-274-0456"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.