| Dr. Smile San Pedro | |
|
1622 S Gaffey St Suite #102 San Pedro CA 90731-4658 | |
| (310) 548-8128 | |
| (310) 548-8138 |
| Full Name | Dr. Smile San Pedro |
|---|---|
| Speciality | Clinic/Center |
| Location | 1622 S Gaffey St, San Pedro, California |
| Authorized Official Name and Position | Kayvon Javid (OWNER/DDS) |
| Authorized Official Contact | 3105488128 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Smile San Pedro 1622 S Gaffey St Suite #102 San Pedro CA 90731-4658 Ph: (310) 548-8128 | Dr. Smile San Pedro 1622 S Gaffey St Suite #102 San Pedro CA 90731-4658 Ph: (310) 548-8128 |
| NPI Number | 1144771445 |
|---|---|
| Provider Enumeration Date | 10/21/2016 |
| Last Update Date | 07/08/2022 |
| Medicare PECOS PAC ID | 3072998400 |
|---|---|
| Medicare Enrollment ID | O20220920003742 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144771445 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 48617 (California) | Secondary |
| 261QS0112X | Clinic/center - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Kayvon Javid |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1073697348 PECOS PAC ID: 5294974804 Enrollment ID: I20130611000695 |
Coeli Tuvera Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 312 N Gaffey St, Suite 201, San Pedro, CA 90731 Phone: 310-833-7348 Fax: 310-833-0697 | |
Consumerhealth, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 697 S Gaffey St, San Pedro, CA 90731 Phone: 310-548-1273 | |
San Pedro Family Dentist Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 204 N Pacific Ave, San Pedro, CA 90731 Phone: 310-832-8800 Fax: 310-832-8801 | |
Assistance League Of San Pedro-south Bay Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1441 W 8th St, San Pedro, CA 90732 Phone: 310-832-8355 Fax: 310-832-8460 | |
Herbert G Martin Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1360 W 6th St, #110, San Pedro, CA 90732 Phone: 310-833-4439 Fax: 310-833-4999 | |
Dr. Jacqueline Cootes, Dds Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 732 W 9th St Ste 204, San Pedro, CA 90731 Phone: 310-833-1386 |