Active NPI
Yvette Gulesserian, DDS
- Dentist
- Los Angeles, CA
National Provider Identifier
1043344096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D46598
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161219002355 | CA | Order and Referring Only - Dentist | 0840571451 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D46598 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dae H Song DDS Inc | Dentist | Past | Accepting new patients |
| Rafik Meserkhani & Yvette M Gulesserian D.D.S Inc. | Dentist | Past | 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.
-
- General Practice Dentistry
- Los Angeles, CA
- NPI 1912864760
-
- Dentist
- Los Angeles, CA
- NPI 1831211820
-
- Oral and Maxillofacial Surgery Clinic/Center
- Burbank, CA
- NPI 1346458114
Dentist
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.