Individual provider Active NPI

Ara A Derkejian

  • Dentist
  • Palmdale, CA
National Provider Identifier
1154504140
Registry record updated Jan 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
55989 Issued in CA
Practice address
38745 Tierra Subida Ave
Suite # 150
Palmdale, CA 93551-4540
Phone
(661) 272-9091
NPI assigned
Dec 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 55989 CA Primary

Addresses

Primary practice location

38745 Tierra Subida Ave
Suite # 150
Palmdale, CA 93551-4540

Mailing address

38745 Tierra Subida Ave
Suite # 150
Palmdale, CA 93551-4540
Phone (661) 272-9091

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

Interoperability endpoints

  • Direct secure messaging: aderkejian@direct.westerndental.com

NPI Registry JSON

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200182400000",
    "number": "1154504140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38745 TIERRA SUBIDA AVE",
            "address_2": "SUITE # 150",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935514540",
            "telephone_number": "661-272-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38745 TIERRA SUBIDA AVE",
            "address_2": "SUITE # 150",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935514540",
            "telephone_number": "661-272-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERKEJIAN",
        "first_name": "ARA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-12",
        "last_updated": "2008-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "55989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2008; 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.