Individual provider Active NPI

Rosemary Baghdassarian, DDS

  • General Practice Dentistry
  • Greensboro, NC
National Provider Identifier
1184846867
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12608 Issued in NC
Practice address
5923 W Friendly Ave Ste a
Greensboro, NC 27410-3207
Phone
(336) 632-0744
Fax
(336) 632-0754
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN14712 FL
General Practice Dentistry 1223G0001X 12608 NC Primary

Addresses

Primary practice location

5923 W Friendly Ave Ste a
Greensboro, NC 27410-3207

Mailing address

5923 W Friendly Ave Ste a
Greensboro, NC 27410-3207
Phone (336) 632-0744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230614000257 NC Order and Referring Only - DentistPractitioner - Dentist 3870670383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN14712FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Hab Boca Raton Dentist Current Accepting new patients
Lane and Associates L DDS PA Dentist PastSince Apr 23, 2023 Accepting new patients

Locations

12453 Hagen Ranch Rd
Unit 101
Boynton Beach, FL 33437
Phone (561) 221-0450

Networks

  • Freedom Health HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1184846867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5923 W FRIENDLY AVE STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274103207",
            "telephone_number": "336-632-0744",
            "fax_number": "336-632-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5923 W FRIENDLY AVE STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274103207",
            "telephone_number": "336-632-0744",
            "fax_number": "336-632-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGHDASSARIAN",
        "first_name": "ROSEMARY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN14712",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.