Tatyana Prosolupova

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

105166 Issued in CA

Practice address

1431 W Knox St Ste 800
Torrance, CA 90501-1358

Phone

(310) 320-1180

NPI assigned

Aug 4, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Serenity Grove Dental PLLC

  • Dental Clinic/Center
  • Loxahatchee, FL
  • NPI 1598513327
  NPD Authorized official
• Joseph Fahr DDS Inc

  • General Practice Dentistry
  • Torrance, CA
  • NPI 1184247728
  NPD
• Joseph P Fahr

  • General Practice Dentistry
  • Torrance, CA
  • NPI 1366714222
  NPD (past)

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1992315998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 11TH ST APT C",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902544296",
            "telephone_number": "213-239-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 W KNOX ST STE 800",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905011358",
            "telephone_number": "310-320-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSOLUPOVA",
        "first_name": "TATYANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prohealth Partners, a Medical Group, Inc.
• Prohealth Partners, a Medical Group, Inc.
• Mary Frances Promutico
• Proper Med
• Sara Props-Moyer
• Prosperous Corp of America
• Prosthetic & Orthotic Group, Inc
• Protestant John Calvin Medical Center
• Stephen Erwin Prover, M.D.
• Providence Health System - Southern California

• General Practice Dentistry in Torrance, CA
• Providers in Torrance, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.