NPIMap

Organization Active NPI

Westside Pediatric Dental Group

  • Pediatric Dentistry
  • Santa Monica, CA
National Provider Identifier
1871871707
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
WESTSIDE PEDIATRIC DENTAL GROUP
Practice address
1243 7TH St
Santa Monica, CA 90401-1600
Phone
(310) 451-5748
NPI assigned
Jul 26, 2011
Last updated
Jul 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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

Authorized official

Name
Dr. Emmanuel Bernard Gross, DDSNPI 1407839053
Title
Partner
Phone
(310) 451-5748

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X Primary

Addresses

Primary practice location

1243 7TH St
Santa Monica, CA 90401-1600

Mailing address

1243 7TH St
Santa Monica, CA 90401-1600
Phone (310) 451-5748

National Provider Directory

National Provider Directory
Tax ID family
Westside Pediatric Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1243 7th St
Santa Monica, CA 90401
Phone (310) 451-5748

Practitioners & affiliated clinicians

Practitioners 2

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": "1311638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311638400000",
    "number": "1871871707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1243 7TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011600",
            "telephone_number": "310-451-5748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 7TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011600",
            "telephone_number": "310-451-5748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE PEDIATRIC DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-26",
        "last_updated": "2011-07-26",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "310-451-5748",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.