Individual provider Active NPI

Hamlet Charmahali Garabedian, DMD, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Glendale, CA
National Provider Identifier
1316081623
Registry record updated Jul 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
95221 Issued in CA
Practice address
242 N Glendale Ave
Glendale, CA 91206-4454
Phone
(818) 484-8939
Fax
(818) 649-1207
NPI assigned
Feb 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2014

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 22DI02285600 NJ
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 13299 MD
Oral and Maxillofacial Surgery (Dentist) 1223S0112X OMS72 CA
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 25MA08020700 NJ
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 95221 CA Primary

Addresses

Primary practice location

242 N Glendale Ave
Glendale, CA 91206-4454

Mailing address

242 N Glendale Ave
Glendale, CA 91206-4454
Phone (818) 484-8939

Other identifiers 1

IdentifierTypeStateIssuer
G0945AOtherCAPTAN

Other names 1

  • Dr. Hamlet Charmahali Former name

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121119000177 CA Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 6103077722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Maxillofacial Surgery
Education
Harvard School of Dental Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Garabedian and Kotikian Dental CorporationGroup PAC ID 3577714195, 2 clinicians

Practice addresses (Care Compare)

242 N Glendale Ave
Glendale, CA 91206-4454
Phone (818) 484-8939

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
OMS72CAMDOral and Maxillofacial Surgery (Dentist)
13299MDMDOral and Maxillofacial Surgery (Dentist)
22DI02285600NJMDOral and Maxillofacial Surgery (Dentist)
95221CAMDOral & Maxillofacial Surgery (D.M.D.)
25MA08020700NJMDOral & Maxillofacial Surgery (D.M.D.)

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406505600000",
    "number": "1316081623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 N GLENDALE AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064454",
            "telephone_number": "818-484-8939",
            "fax_number": "818-649-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 N GLENDALE AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064454",
            "telephone_number": "818-484-8939",
            "fax_number": "818-649-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARABEDIAN",
        "first_name": "HAMLET",
        "middle_name": "CHARMAHALI",
        "name_prefix": "Dr.",
        "credential": "DMD, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2014-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02285600",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "13299",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "OMS72",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NJ",
            "license": "25MA08020700",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "95221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "G0945A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAMLET",
            "last_name": "CHARMAHALI",
            "prefix": "DR.",
            "credential": "DMD, MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.