LARISSA GUSHANSKY, DDS INC. NPI 1003000928

Dentist in Pomona, CA

Organization Dentist

About LARISSA GUSHANSKY, DDS INC.

Larissa Gushansky, Dds Inc. is a provider established in Pomona, California specializing in dentist. The NPI number of Larissa Gushansky, Dds Inc. is 1003000928 and was assigned on September 2007. The practitioner's primary taxonomy code is 122300000X with license number 36156 (CA). The provider is registered as an organization and their NPI record was last updated 12 years ago. Larissa Gushansky, Dds Inc. operates as a single speciality business group with one or more individual providers who practice the same area of specialization.
The authorized official of this NPI record is Dr. Larissa Gushansky (President)

NPI

1003000928

Provider NameLARISSA GUSHANSKY, DDS INC.
Provider Location Address887 E 2ND ST SUITE B POMONA, CA 91766
Provider Mailing Address887 E 2ND ST SUITE B POMONA, CA 91766
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date09-04-2007
Last Update Date09-04-2007

Primary Taxonomy

Taxonomy Code122300000X
ClassificationDentist
TypeDental Providers
License No.36156
License StateCA
Taxonomy DescriptionA dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Business Address

LARISSA GUSHANSKY, DDS INC.
887 E 2ND ST
SUITE B
POMONA, CA
ZIP 91766
Phone: (909) 865-8595

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Mailing Address

LARISSA GUSHANSKY, DDS INC.
887 E 2ND ST
SUITE B
POMONA, CA
ZIP 91766
Phone: (909) 865-8595

Authorized Official

Authorized Official NameDR. LARISSA GUSHANSKY
Authorized Official TitlePRESIDENT
Authorized Official Phone(323) 563-9124

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
B36156-02OTHER (01)CA

Other Providers at the same location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1073594131DR. SUSAN MACKINTOSH D.O.
Individual
Family Medicine887 E 2ND ST SUITE C
POMONA, CA 91766
(909) 865-2565
1336166180 MEHUL SHAILESH SONAWALA M.D.
Individual
Internal Medicine887 E 2ND ST
POMONA, CA 91766
(909) 620-7769
1760860894JOSEPH M MOLINA MD PROFESSIONAL CORPORATION SOUTHERN CA
Organization
Non-Pharmacy Dispensing Site887 E 2ND ST
POMONA, CA 91766
(909) 620-7769
1982750287DR. ASHEESH PASI MD
Individual
Family Medicine887 E 2ND ST
POMONA, CA 91766
(909) 467-0797

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.

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