Individual provider Active NPI

Tigran Arakelyan

  • General Practice Dentistry
  • Pasadena, CA
National Provider Identifier
1053458059
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
46738 Issued in CA
Practice address
720 N Lake Ave Ste 7
Pasadena, CA 91104-5810
Phone
(626) 808-9797
Fax
(626) 808-9786
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
Yes

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
General Practice Dentistry 1223G0001X 46738 CA Primary

Addresses

Primary practice location

720 N Lake Ave Ste 7
Pasadena, CA 91104-5810

Mailing address

720 N Lake Ave Ste 7
Pasadena, CA 91104-5810
Phone (626) 808-9797

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
46738CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053458059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 N LAKE AVE STE 7",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911045810",
            "telephone_number": "626-808-9797",
            "fax_number": "626-808-9786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N LAKE AVE STE 7",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911045810",
            "telephone_number": "626-808-9797",
            "fax_number": "626-808-9786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARAKELYAN",
        "first_name": "TIGRAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.