Erez Nosrati, DMD, Inc.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

EREZ NOSRATI, DMD, INC.

Practice address

525 Nautilus St
La Jolla, CA 92037-6139

Phone

(312) 731-5554

NPI assigned

Mar 20, 2018

Organization subpart

No

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

Authorized official

Name

Erez Nosrati, DMD

Title

President

Phone

(312) 731-5554

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521504000000",
    "number": "1902300320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5175 PEARLMAN WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303715",
            "telephone_number": "312-731-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 NAUTILUS ST",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920376139",
            "telephone_number": "312-731-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EREZ NOSRATI, DMD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-20",
        "last_updated": "2018-03-20",
        "status": "A",
        "authorized_official_last_name": "NOSRATI",
        "authorized_official_first_name": "EREZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-731-5554",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; 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.