Vahe Antanesian, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

46236 Issued in CA

Practice address

5819 Adenmoor Ave
Lakewood, CA 90713-1067

Phone

(805) 570-0600

Fax

(805) 579-3792

NPI assigned

Jun 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lakewood Cerritos Dental Center

  • General Practice Dentistry
  • Lakewood, CA
  • NPI 1164979944
  NPD (past) Authorized official
• Lakewood Cerritos Dental CTRS

  • General Practice Dentistry
  • Lakewood, CA
  • NPI 1407124290
  NPD (past)

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1285838730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 E LOS ANGELES AVE STE F",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633300",
            "telephone_number": "805-570-0600",
            "fax_number": "805-579-3792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5819 ADENMOOR AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907131067",
            "telephone_number": "805-570-0600",
            "fax_number": "805-579-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTANESIAN",
        "first_name": "VAHE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Christopher Andrew Arceo
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• Lizette Arechiga
• Andrew James Arellano

• General Practice Dentistry in Lakewood, CA
• Providers in Lakewood, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.