Individual provider Active NPI

Edward C Terzian, D.M.D., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Los Angeles, CA
National Provider Identifier
1265630065
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
OMS79 Issued in CA
Practice address
5162 Whittier Blvd
Los Angeles, CA 90022-3932
Phone
(310) 779-9418
NPI assigned
Jul 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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 OMS79 CA Primary

Addresses

Primary practice location

5162 Whittier Blvd
Los Angeles, CA 90022-3932

Mailing address

2029 Verdugo Blvd # 151
Montrose, CA 91020-1626
Phone (310) 779-9418

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
OMS79CAMDOral and Maxillofacial Surgery (Dentist)

Interoperability endpoints

  • Direct secure messaging: eterzian@direct.westerndental.com

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1265630065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 VERDUGO BLVD # 151",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201626",
            "telephone_number": "310-779-9418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5162 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900223932",
            "telephone_number": "310-779-9418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERZIAN",
        "first_name": "EDWARD",
        "middle_name": "C",
        "credential": "D.M.D., M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2021-10-06",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "OMS79",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.