Larchmont Village Dental Specialty Center, Inc.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DDS45489 Issued in CA

Legal business name

LARCHMONT VILLAGE DENTAL SPECIALTY CENTER, INC.

Practice address

321 N Larchmont Blvd Ste 721
Los Angeles, CA 90004-6407

Phone

(323) 465-3116

NPI assigned

Dec 14, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Kwor Chieh Loo, DDS

Title

Owner

Phone

(626) 475-7424

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• George Bogen, DDS

  • Endodontics
  • Los Angeles, CA
  • NPI 1477692317
  NPD (past)

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

{
    "created_epoch": "1513209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1922514819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N LARCHMONT BLVD STE 721",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900046407",
            "telephone_number": "323-465-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N LARCHMONT BLVD STE 721",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900046407",
            "telephone_number": "323-465-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARCHMONT VILLAGE DENTAL SPECIALTY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-14",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "LOO",
        "authorized_official_first_name": "KWOR",
        "authorized_official_middle_name": "CHIEH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-475-7424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "DDS45489",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larchmont Optometrics, Inc
• Larchmont Pediatrics, Inc.
• Larchmont Radiology
• Larchmont Surgery Center, LLC
• Larchmont Traditional Medicine
• Mary Zizapezemi Lardge
• Christina Lares, MPH, MA, DOULA
• Pedro Lares
• Socorro G Lares, LVN
• Renee Nichole Largaespada

• Endodontics in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.