Individual provider Active NPI

Gebin Zhu, DDS

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1972343135
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
110325 Issued in CA
Practice address
808 W 58TH St
Los Angeles, CA 90037-3632
Phone
(323) 541-1411
NPI assigned
May 27, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019035003 IL
Dentist 122300000X 110325 CA Primary

Addresses

Primary practice location

808 W 58TH St
Los Angeles, CA 90037-3632

Mailing address

808 W 58TH St
Los Angeles, CA 90037-3632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240719003250 CA Practitioner - Dentist 2961948450 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110325CAMDDentist
019035003ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Community Health Current Accepting new patients
St. Johns Community Health CurrentSince Jul 16, 2024 Accepting new patients
St. Johns Community Health CurrentSince Jul 16, 2024 Accepting new patients
St. Johns Community Health Past Accepting new patients

Locations

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

1821 S San Jacinto Ave
Ste D
San Jacinto, CA 92583
Phone 32328598302332

1500 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 381-1591

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1716768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1972343135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 W 58TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900373632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 W 58TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900373632",
            "telephone_number": "323-541-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHU",
        "first_name": "GEBIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-27",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019035003",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "110325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.