Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
KONVISER DENTAL PROFESSIONAL CORPORATION
Active
Organization
KONVISER DENTAL PROFESSIONAL CORPORATION
Active
Other names
OceanBreeze Dental
Organization subpart
No
Provider details
NPI number
Authorized official
VADIM KONVISER DDS (CEO)
(310) 578-2500
Entity
Organization
Contact information
Practice address
4644 LINCOLN BLVD STE 404, MARINA DEL REY, CA 90292-6380
(310) 578-2500
Mailing address
4644 LINCOLN BLVD STE 404, MARINA DEL REY, CA 90292-6380
(310) 578-2500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
51095
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
51095
CA
Other
Enumeration date
08/29/2018
Last updated
08/29/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers