Individual provider Active NPI

Angela Annie Terzian, D.D.S.

  • General Practice Dentistry
  • Glendale, CA
National Provider Identifier
1275845984
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
60665 Issued in CA
Practice address
428 Arden Ave Ste 200
Glendale, CA 91203-4012
Phone
(818) 848-5591
NPI assigned
Jul 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 60665 CA Primary

Addresses

Primary practice location

428 Arden Ave Ste 200
Glendale, CA 91203-4012

Mailing address

2944 El Caminito
La Crescenta, CA 91214-2005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20151020002948 CA Order and Referring Only - DentistPractitioner - Dentist 8224347943

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60665CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Christie H. Park, DDS, Inc. PastSince Dec 21, 2021 Accepting new patients

Organizations & group practices 1

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": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1275845984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2944 EL CAMINITO",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912142005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 ARDEN AVE STE 200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912034012",
            "telephone_number": "818-848-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERZIAN",
        "first_name": "ANGELA",
        "middle_name": "ANNIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-10",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "60665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.