Active NPI
Fredrick Grigorian, DENTIST
- General Practice Dentistry
- Sun Valley, CA
National Provider Identifier
1114195773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 54143
- Practice address
- 8454 Sunland Blvd
Sun Valley, CA 91352-3436 - Phone
- (818) 767-1800
- Fax
- (818) 714-2358
- NPI assigned
- Feb 18, 2008
- Last updated
- Jan 22, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 54143 | CA | |
| General Practice Dentistry | 1223G0001X | 54143 | CA | Primary |
Addresses
Primary practice location
8454 Sunland Blvd
Sun Valley, CA 91352-3436
Mailing address
8454 Sunland Blvd
Sun Valley, CA 91352-3436
Phone (818) 415-7556
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 54143 | Other | CA | DENTI-CAL |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Express Medical Supplies, Inc. | Past | Accepting new patients | |
| Abrahamian DDS, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- Sun Valley, CA
- NPI 1952934143
-
- Durable Medical Equipment & Medical Supplies
- Sun Valley, CA
- NPI 1669776191
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516579200000",
"number": "1114195773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8454 SUNLAND BLVD",
"city": "SUN VALLEY",
"state": "CA",
"postal_code": "913523436",
"telephone_number": "818-415-7556",
"fax_number": "818-714-2358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8454 SUNLAND BLVD",
"city": "SUN VALLEY",
"state": "CA",
"postal_code": "913523436",
"telephone_number": "818-767-1800",
"fax_number": "818-714-2358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIGORIAN",
"first_name": "FREDRICK",
"name_prefix": "Dr.",
"credential": "DENTIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-18",
"last_updated": "2018-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "54143",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "54143",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTI-CAL",
"identifier": "54143",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sun Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.