NPIMap

Organization Active NPI

Dentalville

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1871772368
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3580 Issued in NV
Legal business name
DENTALVILLE
Practice address
1180 S Beverly Dr Ste 401
Los Angeles, CA 90035-1156
Phone
(310) 804-1972
NPI assigned
Oct 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Authorized official

Name
Marina Kozyr
Title
Regional Manager
Phone
(310) 804-1972

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 3580 NV Primary

Addresses

Primary practice location

1180 S Beverly Dr Ste 401
Los Angeles, CA 90035-1156

Mailing address

945 S Rainbow Blvd
Las Vegas, NV 89145-6230
Phone (702) 258-8216

Other names 1

  • Arthur Glosman DDS LTD Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Dentalville6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1180 S Beverly Dr
Ste 401
Los Angeles, CA 90035
Phone (310) 804-1972

945 S Rainbow Blvd
Las Vegas, NV 89145
Phone (702) 331-8585

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1871772368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 S RAINBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891456230",
            "telephone_number": "702-258-8216",
            "fax_number": "702-870-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 S BEVERLY DR STE 401",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351156",
            "telephone_number": "310-804-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTALVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "KOZYR",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "310-804-1972"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NV",
            "license": "3580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arthur Glosman DDS LTD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Oct 31, 2007; 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.