WESTSIDE PEDIATRIC DENTAL GROUP (NPI# 1235506312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235506312 |
| Entity Type | Organization |
| Organization Name | WESTSIDE PEDIATRIC DENTAL GROUP |
| Practice Address |
1304 15th St Ste 206 Santa Monica CA 90404-1811 |
| Practice Telephone | 3104515748 |
| Practice Fax Number | 3103939528 |
| Mailing Telephone | 3104515748 |
| Mailing Fax Number | 3103939528 |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2015-08-25 |
| Authorized Official Name | DR. EMMANUEL BERNARD GROSS (OWNER) |
| Authorized Official Telephone | 3104515748 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
59919 | CA | Dental Providers |
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
31742 | CA | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
39266 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871871707 | Westside Pediatric Dental Group | Dentist | 1243 7th St, Santa Monica, CA 90401-1600 | 2011-07-26 |
| Street Address |
1304 15TH ST STE 206 |
| City | SANTA MONICA |
| State | CA |
| Zip Code | 90404-1811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306453352 | Jasmine Burton | Physical Therapist | 1714 17th Street, Santa Monica, CA 90404 | 2020-09-24 |
| 1003431685 | Cintia Haydee Ctibor | Behavior Technician | 1869 9th Street, Santa Monica, CA 90404 | 2020-06-10 |
| 1073137261 | Sydney Kristine Valerio | Counselor | 1869 9th St, Santa Monica, CA 90404 | 2020-06-03 |
| 1710507082 | James Gilbert Cunningham | Marriage & Family Therapist | 1708 Olympic Blvd, Santa Monica, CA 90404 | 2020-04-16 |
| 1841763687 | Crystal Monique Mckinley X | Counselor | 1865 9th St, Santa Monica, CA 90404 | 2019-01-04 |
| 1952872749 | Cesar O Munoz | Licensed Vocational Nurse | 1865 9th St., Santa Monica, CA 90404 | 2018-12-06 |
| 1023596574 | Joseph J Pinzone Md Inc | Internal Medicine | 2001 Santa Monica Blvd Ste 1190, Santa Monica, CA 90404 | 2018-08-06 |
| 1548763535 | Alan Rubenstein Dds Inc | Dentist | 1260 15th St., #703, Santa Monica, CA 90404 | 2018-03-15 |
| 1669993382 | Aaron Wilson | Counselor | 1453 16th Street, Santa Monica, CA 90404 | 2017-07-03 |
| 1922472471 | Chianni Lin | Acupuncturist | 2222 Santa Monica Blvd, Ste. 105, Santa Monica, CA 90404 | 2015-11-20 |
| Find all providers in zip 90404 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730467903 | Magnolia Becker | Dentist | 1440 23rd St Apt 210, Santa Monica, CA 90404-2948 | 2011-07-22 |
| 1821139569 | Ellen Hillary Stone | Dentist | 2825 Santa Monica Blvd., Suite 301, Santa Monica, CA 90404 | 2007-02-08 |
| 1679664205 | Noushin Morshed | Dentist | 1244 7th St, Suite 202, Santa Monica, CA 90401-1648 | 2006-09-27 |
| 1407839053 | Emmanuel Bernard Gross | Dentist | 1243 7th St, Suite # C, Santa Monica, CA 90401-1605 | 2005-11-28 |
| 1871871707 | Westside Pediatric Dental Group | Dentist | 1243 7th St, Santa Monica, CA 90401-1600 | 2011-07-26 |
| 1760409692 | Indulal M. Nagrecha | Dentist | 2509 Pico Blvd, Venice Family Clinic, Santa Monica, CA 90405-1828 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790385227 | Johnson Ann Wong Dental Corporation | Dentist | 6512 N Figueroa St Ste 3, Los Angeles, CA 90042-2155 | 2020-10-26 |
| 1205440211 | Jessica Choi, Dmd, Dental Corporation | Dentist | 2318 Huntington Dr, San Marino, CA 91108-2641 | 2020-09-08 |
| 1659985802 | Rw Fattouch Dmd, Inc. | Dentist | 42210 Lyndie Ln Ste 100, Temecula, CA 92591-3604 | 2020-09-04 |
| 1174136998 | Armand Begian Dds Inc. | Dentist | 4021 Mission Oaks Blvd # 180, Camarillo, CA 93012-5156 | 2020-08-31 |
| 1164035473 | Armand Begian Dds Inc. | Dentist | 3687 Las Posas Rd Ste 180, Camarillo, CA 93010-1431 | 2020-08-26 |
| 1518577972 | Michael Vincent Laureola Dds Inc | Dentist | 2862 Unit A Canyon Springs Parkway, Riverside, CA 92507 | 2020-07-31 |
| 1396360384 | Drs Salem and Soliman Dental Corp | Dentist | 2119 E Hatch Rd Ste Bandc, Modesto, CA 95351-4814 | 2020-06-15 |
| 1689299471 | Abhishek Batra | Dentist | 11052 Evans St, Loma Linda, CA 92354-2709 | 2020-06-08 |
| 1194348060 | Bryan Chao | Dentist | 1895 Mowry Ave Ste 121, Fremont, CA 94538-1736 | 2020-05-26 |
| 1255953618 | Mohammad Abul-fielat Dds Inc | Dentist | 3825 Tyler St, Riverside, CA 92503 | 2020-05-08 |
| Find all providers with the same taxonomy | ||||
| City | SANTA MONICA |
| Zip Code | 90404 |
Please comment or provide details below to improve the information on WESTSIDE PEDIATRIC DENTAL GROUP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.