MEDICARE: DR. GREGORY D KAPLAN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	32932	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	32932	OTHER	CA	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1982674529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY D KAPLAN D.D.S.

Provider Business Mailing Address
First Line	:	3932 WILSHIRE BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-3307
Country	:	US
Telephone Number	:	213-386-3336
Fax Number	:	213-386-2935

Provider Business Practice Location Address
First Line	:	3932 WILSHIRE BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-3307
Country	:	US
Telephone Number	:	213-386-3336
Fax Number	:	213-386-2935

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	07/08/2007

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