Individual provider Active NPI

Deena Hovsepian, DDS

  • General Practice Dentistry
  • Rancho Mirage, CA
National Provider Identifier
1053056283
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
107759 Issued in CA
Practice address
71949 Highway 111 Ste 100B
Rancho Mirage, CA 92270-4826
Phone
(760) 565-6055
NPI assigned
May 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 107759 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

71949 Highway 111 Ste 100B
Rancho Mirage, CA 92270-4826

Mailing address

12740 N Watt LN Unit E
Sylmar, CA 91342-4889
Phone (818) 445-5272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
107759CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1053056283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12740 N WATT LN UNIT E",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913424889",
            "telephone_number": "818-445-5272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71949 HIGHWAY 111 STE 100B",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704826",
            "telephone_number": "760-565-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOVSEPIAN",
        "first_name": "DEENA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107759",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.