Individual provider Active NPI

Yvette Gulesserian, DDS

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1043344096
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D46598 Issued in CA
Practice address
3129 N San Fernando Rd
Los Angeles, CA 90065-1412
Phone
(323) 257-7744
Fax
(323) 257-5430
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D46598 CA Primary

Addresses

Primary practice location

3129 N San Fernando Rd
Los Angeles, CA 90065-1412

Mailing address

5442 Pineridge Dr
La Crescenta, CA 91214-1434
Phone (818) 541-0357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161219002355 CA Order and Referring Only - DentistPractitioner - Dentist 0840571451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D46598CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dae H Song DDS Inc Dentist Past Accepting new patients
Rafik Meserkhani & Yvette M Gulesserian D.D.S Inc. Dentist PastSince Dec 1, 2022 Accepting new patients
Chang Woo Lee, D.D.S., Professional Corporation Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043344096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5442 PINERIDGE DR",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912141434",
            "telephone_number": "818-541-0357",
            "fax_number": "323-257-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3129 N SAN FERNANDO RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900651412",
            "telephone_number": "323-257-7744",
            "fax_number": "323-257-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULESSERIAN",
        "first_name": "YVETTE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "D46598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.