Individual provider Active NPI

Nelly Bezimyansky, DDS

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1972525855
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
50040 Issued in CA
Practice address
6360 Wilshire Blvd Ste 510
Los Angeles, CA 90048-5601
Phone
(323) 655-0855
NPI assigned
Jul 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 50040 CA Primary

Addresses

Primary practice location

6360 Wilshire Blvd Ste 510
Los Angeles, CA 90048-5601

Mailing address

850 N Croft Ave
#305
Los Angeles, CA 90069-4287
Phone (323) 655-7007

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
I20150522001587 CA Practitioner - Oral Surgery 6103144175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Univ of Calif, Los Angeles School of Dentistry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6360 Wilshire Blvd
Suite 510
Los Angeles, CA 90048-5601
Phone (323) 655-0865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50040CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nelly Bezimyansky DDS, Inc. Dentist CurrentSince Jul 21, 2007 Accepting new patients

Locations

6360 Wilshire Blvd
Ste 510
Los Angeles, CA 90048
Phone (323) 653-0230

Organizations & group practices 1

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": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1972525855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 N CROFT AVE",
            "address_2": "#305",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900694287",
            "telephone_number": "323-655-7007",
            "fax_number": "270-447-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 WILSHIRE BLVD STE 510",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485601",
            "telephone_number": "323-655-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEZIMYANSKY",
        "first_name": "NELLY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "50040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.