Individual provider Active NPI

Jacqueline S Chibarian, DDS

  • Dentist
  • Glendale, CA
National Provider Identifier
1104041128
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
41821 Issued in CA
Practice address
3600 Ocean View
#6
Glendale, CA 91208
Phone
(818) 541-9010
Fax
(818) 541-9019
NPI assigned
Apr 16, 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 41821 CA Primary

Addresses

Primary practice location

3600 Ocean View
#6
Glendale, CA 91208

Mailing address

3600 Ocean View
#6
Glendale, CA 91208
Phone (818) 541-9010

Other identifiers 1

IdentifierTypeStateIssuer
D41821MedicaidCA

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
I20160520000716 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3870882426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41821CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Aslanyan DDS and Jaqueline Chibarian DDS a Professional Dental Dentist Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104041128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 OCEAN VIEW",
            "address_2": "#6",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91208",
            "telephone_number": "818-541-9010",
            "fax_number": "818-541-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 OCEAN VIEW",
            "address_2": "#6",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91208",
            "telephone_number": "818-541-9010",
            "fax_number": "818-541-9019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIBARIAN",
        "first_name": "JACQUELINE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "41821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D41821",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.