Grant A Loosvelt, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

47389 Issued in CA

Practice address

2080 Century Park E
Suite 1601
Los Angeles, CA 90067-2001

Phone

(310) 277-5678

Fax

(310) 277-3294

NPI assigned

May 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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 Sep 24, 2019 through Sep 24, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• William M. Dorfman D.D.S.

  • Dental Clinic/Center
  • Los Angeles, CA
  • NPI 1386572030
  NPD (past)

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821209776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK E",
            "address_2": "SUITE 1601",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900672001",
            "telephone_number": "310-277-5678",
            "fax_number": "310-277-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK E",
            "address_2": "SUITE 1601",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900672001",
            "telephone_number": "310-277-5678",
            "fax_number": "310-277-3294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOOSVELT",
        "first_name": "GRANT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "47389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Lee Loomis
• Katherine Loomis, OTR/L, CHT
• Katherine Amalia Loomis, MD
• Gillian Wei-Yi Quian Loon, CRNA
• William C. Loos, MD
• Ma Ledi Ham Barretto Loot, PMHNP
• Elnaz Looyzadeh, PA-S
• Nilda E Lopapa
• Claire Nicole Lopaty, LMFT
• Kasarri Tiana Loper, OT

• Dentist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dentist in California

• 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.

Verify at the official NPI Registry.