Individual provider Active NPI

Ivana Younan

  • Dentist
  • Canyon Country, CA
National Provider Identifier
1265105936
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
106441 Issued in CA
Practice address
18635 Soledad Canyon Rd
Ste 108
Canyon Country, CA 91351
Phone
(661) 299-2525
NPI assigned
Jul 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 106441 CA Primary

Addresses

Primary practice location

18635 Soledad Canyon Rd
Ste 108
Canyon Country, CA 91351

Mailing address

15805 Mandalay Rd
Canyon Country, CA 91387

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

State licenses

LicenseStateTypeSpecialty
106441CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Alexander Lee Dental Corporation CurrentSince Mar 17, 2024 Accepting new patients
Gina Dorfman, D.D.S., a.P.C. PastSince Aug 1, 2021 Accepting new patients

Locations

18635 Soledad Canyon Rd
Ste 108
Canyon Country, CA 91351
Phone (661) 299-2525

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": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1265105936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15805 MANDALAY RD",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "91387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18635 SOLEDAD CANYON RD",
            "address_2": "STE 108",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "91351",
            "telephone_number": "661-299-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNAN",
        "first_name": "IVANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "106441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canyon Country, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.