NPIMap

Organization Active NPI

Angela Ayzin DDS and Van Ayzin DDS a Dental Coporation

  • Dentist
  • Glendale, CA
National Provider Identifier
1164585832
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
34050 Issued in CA
Legal business name
ANGELA AYZIN DDS AND VAN AYZIN DDS A DENTAL COPORATION
Practice address
815 So Central Ave
Suite 10
Glendale, CA 91204-2079
Phone
(818) 240-5800
Fax
(818) 240-5801
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Yan Ayzin, DDSNPI 1073710240
Title
Corporate Officer
Phone
(818) 240-5800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 41813 CA
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 34050 CA Primary

Addresses

Primary practice location

815 So Central Ave
Suite 10
Glendale, CA 91204-2079

Mailing address

815 So Central Ave
Suite 10
Glendale, CA 91204-2079
Phone (818) 240-5800

Other identifiers 1

IdentifierTypeStateIssuer
G9296401MedicaidCA

National Provider Directory

National Provider Directory

Locations

815 S Central Ave
Ste 10
Glendale, CA 91204
Phone (818) 240-5800

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164585832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 SO CENTRAL AVE",
            "address_2": "SUITE 10",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042079",
            "telephone_number": "818-240-5800",
            "fax_number": "818-240-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 SO CENTRAL AVE",
            "address_2": "SUITE 10",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042079",
            "telephone_number": "818-240-5800",
            "fax_number": "818-240-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELA AYZIN DDS AND VAN AYZIN DDS A DENTAL COPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AYZIN",
        "authorized_official_first_name": "YAN",
        "authorized_official_title_or_position": "CORPORATE OFFICER",
        "authorized_official_telephone_number": "818-240-5800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "41813",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "34050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G9296401",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.