Individual provider Active NPI

Girivinothan Palaniswamy, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Rancho Palos Verdes, CA
National Provider Identifier
1902055387
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
52666 Issued in CA
Practice address
28358 S Western Ave
Rancho Palos Verdes, CA 90275-1434
Phone
(310) 547-1128
Fax
(310) 547-1120
NPI assigned
Sep 10, 2008
Last updated
Jun 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 52666 CA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 52666 CA Primary

Addresses

Primary practice location

28358 S Western Ave
Rancho Palos Verdes, CA 90275-1434

Mailing address

28358 S Western Ave
Rancho Palos Verdes, CA 90275-1434
Phone (310) 547-1128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
52666CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph W. Chang, D.D.S., Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1902055387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28358 S WESTERN AVE",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902751434",
            "telephone_number": "310-547-1128",
            "fax_number": "310-547-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28358 S WESTERN AVE",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902751434",
            "telephone_number": "310-547-1128",
            "fax_number": "310-547-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALANISWAMY",
        "first_name": "GIRIVINOTHAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-10",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "52666",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "52666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Palos Verdes, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.