NPIMap

Organization Active NPI

Perio Implant Health Professionals

  • Periodontics
  • Los Angeles, CA
National Provider Identifier
1992914196
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
26091 Issued in CA
Legal business name
PERIO IMPLANT HEALTH PROFESSIONALS
Practice address
1127 Wilshire Blvd
Suite 1110
Los Angeles, CA 90017-3901
Phone
(213) 481-0664
Fax
(213) 481-2902
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. William Matoska, D.D.S.NPI 1437378668
Title
Periodontist
Phone
(213) 481-0664

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
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 26091 CA Primary

Addresses

Primary practice location

1127 Wilshire Blvd
Suite 1110
Los Angeles, CA 90017-3901

Mailing address

1127 Wilshire Blvd
Suite 1110
Los Angeles, CA 90017-3901
Phone (213) 481-0664

National Provider Directory

National Provider Directory

Locations

1127 Wilshire Blvd
Ste 1110
Los Angeles, CA 90017
Phone (213) 481-0664

Practitioners & affiliated clinicians

Practitioners 4

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": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992914196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD",
            "address_2": "SUITE 1110",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900173901",
            "telephone_number": "213-481-0664",
            "fax_number": "213-481-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD",
            "address_2": "SUITE 1110",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900173901",
            "telephone_number": "213-481-0664",
            "fax_number": "213-481-2902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIO IMPLANT HEALTH PROFESSIONALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATOSKA",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PERIODONTIST",
        "authorized_official_telephone_number": "213-481-0664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "26091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 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.