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1528287232 NPI number — GLOSMAN DENTAL GROUP, LTD

NPI Number: 1528287232
Health Care Provider/Practitioner: GLOSMAN DENTAL GROUP, LTD

Information about “1528287232” NPI (GLOSMAN DENTAL GROUP, LTD) exists in 1528287232 in HTML format HTML  |  1528287232 in plain Text format TXT  |  1528287232 in PDF (Portable Document Format) PDF  |  1528287232 in an XML format XML  formats.

NPI Number : 1528287232 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1528287232",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "GLOSMAN DENTAL GROUP, LTD",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "833 W WHITTIER BLVD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MONTEBELLO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90640-4735",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "323-266-1000",
    "MailingAddressFaxNumber": "323-859-3198",
    "FirstLinePracticeLocationAddress": "9210 S. EASTERN AVE #130,",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAS VEGAS",
    "PracticeLocationAddressStateName": "NV",
    "PracticeLocationAddressPostalCode": "89123-4834",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "702-492-6606",
    "PracticeLocationAddressFaxNumber": "702-492-1580",
    "EnumerationDate": "04/24/2007",
    "LastUpdateDate": "07/29/2013",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "GLOSMAN",
    "AuthorizedOfficialFirstName": "MONIQUE",
    "AuthorizedOfficialMiddleName": "R",
    "AuthorizedOfficialTitle": "CHIEF OF STAFF",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DDS",
    "AuthorizedOfficialTelephoneNumber": "310-480-2307",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "1223G0001X",
          "TaxonomyName": "General Practice Dentistry",
          "LicenseNumber": "3580",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "3580",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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