Healthcare Provider Details

I. General information

NPI: 1528070703
Provider Name (Legal Business Name): GREGORY D. KAPLAN,DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3932 WILSHIRE BLVD SUITE 100
LOS ANGELES CA
90010-3307
US

IV. Provider business mailing address

3932 WILSHIRE BLVD SUITE 100
LOS ANGELES CA
90010-3307
US

V. Phone/Fax

Practice location:
  • Phone: 213-386-3336
  • Fax: 213-386-2935
Mailing address:
  • Phone: 213-386-3336
  • Fax: 213-386-2935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number32932
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number32932
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number32932
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number32932
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number32932
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number32932
License Number StateCA
# 7
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number32932
License Number StateCA

VIII. Authorized Official

Name: DR. GREGORY D KAPLAN
Title or Position: DENTIST/ADMINISTRATOR
Credential: DDS
Phone: 213-386-3336