Tenny Balabegian

Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Tujunga, CA

NPI 1346530102 · NPPES record last updated May 8, 2015

Key facts

NPI
1346530102
Entity type
Individual (NPI type 1)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
License
6190 (NV)
Practice address
10028 Leona St
Tujunga, CA 91042-2535
Phone
(818) 399-0550
NPI assigned
Apr 13, 2011
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20151116002640 NV Order and Referring Only - Other (Physician)
Practitioner - Other (Physician)
2567772874

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
63243CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Tenny Balabegian Inc Orthodontics and Dentofacial Orthopedics Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 6190 NV Yes
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 63243 CA

Addresses

Primary practice location

10028 Leona St
Tujunga, CA 91042-2535

Mailing address

10028 Leona St
Tujunga, CA 91042-2535
Phone (818) 399-0550

Other providers in Tujunga, CA

All providers in Tujunga, CA · Orthodontics and Dentofacial Orthopedics Dentistry in California

Sources for this page

Verify at the official NPI Registry.