NPIMap

Organization Active NPI

Mark Treystman DDS Inc

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1972679124
Registry record updated Oct 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
45416 Issued in CA
Legal business name
MARK TREYSTMAN DDS INC
Practice address
6333 Wilshire Blvd
207
Los Angeles, CA 90048-5702
Phone
(323) 653-5484
Fax
(323) 653-5485
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2013

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

Authorized official

Name
Mr. Mark Treystman, DDSNPI 1316131980
Title
Owner
Phone
(323) 653-5484

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 45416 CA Primary

Addresses

Primary practice location

6333 Wilshire Blvd
207
Los Angeles, CA 90048-5702

Mailing address

6333 Wilshire Blvd
207
Los Angeles, CA 90048-5702
Phone (323) 653-5484

Other identifiers 1

IdentifierTypeStateIssuer
D45416MedicaidCA

Other names 1

  • New Century Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

6333 Wilshire Blvd
Ste 207
Los Angeles, CA 90048
Phone (323) 653-5484

8158 Beverly Blvd
Los Angeles, CA 90048
Phone (310) 489-5615

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382659200000",
    "number": "1972679124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6333 WILSHIRE BLVD",
            "address_2": "207",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485702",
            "telephone_number": "323-653-5484",
            "fax_number": "323-653-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 WILSHIRE BLVD",
            "address_2": "207",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485702",
            "telephone_number": "323-653-5484",
            "fax_number": "323-653-5485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK TREYSTMAN DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2013-10-25",
        "status": "A",
        "authorized_official_last_name": "TREYSTMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-653-5484",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "45416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D45416",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Century Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; 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.