Individual provider Active NPI

Martin Stepanyan, D.M.D

  • Oral and Maxillofacial Surgery (Dentist)
  • Pasadena, CA
National Provider Identifier
1164504288
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
45529 Issued in CA
Practice address
301 S Fair Oaks Ave Ste 107
Pasadena, CA 91105-2536
Phone
(626) 440-0099
Fax
(626) 440-1002
NPI assigned
Oct 19, 2006
Sex
Male
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
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 45529 CA Primary

Addresses

Primary practice location

301 S Fair Oaks Ave Ste 107
Pasadena, CA 91105-2536

Mailing address

301 S Fair Oaks Ave Ste 107
Pasadena, CA 91105-2536
Phone (626) 440-0099

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

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164504288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S FAIR OAKS AVE STE 107",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052536",
            "telephone_number": "626-440-0099",
            "fax_number": "626-440-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S FAIR OAKS AVE STE 107",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052536",
            "telephone_number": "626-440-0099",
            "fax_number": "626-440-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPANYAN",
        "first_name": "MARTIN",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "45529",
            "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.