Ida Ganapolsky, D.D.S. a Professional Dental Corp.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34103 Issued in CA

Legal business name

IDA GANAPOLSKY, D.D.S. A PROFESSIONAL DENTAL CORP.

Doing business as

Smiles Dental Practice

Practice address

3356 E Olympic Blvd
Los Angeles, CA 90023-3724

Phone

(323) 269-5221

Fax

(323) 269-5730

NPI assigned

Oct 15, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Rosemary Garcia

Title

Administrator

Phone

(323) 269-5221

Specialties & licenses 1

Addresses

Other names 1

• Smiles Dental Practice Doing business as

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1891984928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3356 E OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900233724",
            "telephone_number": "323-269-5221",
            "fax_number": "323-269-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3356 E OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900233724",
            "telephone_number": "323-269-5221",
            "fax_number": "323-269-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDA GANAPOLSKY, D.D.S. A PROFESSIONAL DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "323-269-5221",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "34103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smiles Dental Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ideal Healthcare Staff Providers

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.