Tina Ghotanian DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

47079 Issued in CA

Legal business name

TINA GHOTANIAN DDS PC

Practice address

10916 Riverside Dr
Toluca Lake, CA 91602-2210

Phone

(818) 762-9966

NPI assigned

Mar 28, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tina Ghotanian, DDSNPI 1366530537

Title

President

Phone

(818) 762-9966

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tina Ghotanian, DDS

  • Dentist
  • Toluca Lake, CA
  • NPI 1366530537
  Authorized official Same address or phone

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235258435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10916 RIVERSIDE DR",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022210",
            "telephone_number": "818-762-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10916 RIVERSIDE DR",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022210",
            "telephone_number": "818-762-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TINA GHOTANIAN DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GHOTANIAN",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-762-9966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "47079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Toluca Lake Home Health Inc
• Toluca Lake Medical Center Inc

• Dentist in Toluca Lake, CA
• Providers in Toluca Lake, CA by specialty
• Dentist in California

• 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.