Alexander Gerbakher DMD Corp

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

44175 Issued in CA

Legal business name

ALEXANDER GERBAKHER DMD CORP

Practice address

12135 Magnolia Blvd
Valley Village, CA 91607-2609

Phone

(818) 761-0001

Fax

(866) 365-9764

NPI assigned

Oct 12, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Alexander I Gerbakher, DMDNPI 1194956326

Title

President

Phone

(818) 761-0001

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Practitioners 1

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

• Alexander Illych Gerbakher, DMD

  • Dentist
  • Valley Village, CA
  • NPI 1194956326
  NPD (past) Authorized official

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

{
    "created_epoch": "1381536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381536000000",
    "number": "1962839795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12135 MAGNOLIA BLVD",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916072609",
            "telephone_number": "818-761-0001",
            "fax_number": "866-365-9764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12135 MAGNOLIA BLVD",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916072609",
            "telephone_number": "818-761-0001",
            "fax_number": "866-365-9764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDER GERBAKHER DMD CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-12",
        "last_updated": "2013-10-12",
        "status": "A",
        "authorized_official_last_name": "GERBAKHER",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-761-0001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "44175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Valley Village, CA
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.