Active NPI
Elmira Amy Latshikyan, D.D.S.
- Dentist
- Irvine, CA
National Provider Identifier
1346623717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 64596
- Practice address
- 17010 Red Hill Ave Ste D
Irvine, CA 92614-5626 - Phone
- (949) 975-0150
- NPI assigned
- Jul 3, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 64596 | CA | Primary |
Addresses
Primary practice location
17010 Red Hill Ave Ste D
Irvine, CA 92614-5626
Mailing address
720 E San Jose Ave Unit 102
Burbank, CA 91501-3606
Phone (818) 631-7072
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161019001917 | CA | Order and Referring Only - Dentist | 0143518498 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435881600000",
"number": "1346623717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 E SAN JOSE AVE UNIT 102",
"city": "BURBANK",
"state": "CA",
"postal_code": "915013606",
"telephone_number": "818-631-7072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17010 RED HILL AVE STE D",
"city": "IRVINE",
"state": "CA",
"postal_code": "926145626",
"telephone_number": "949-975-0150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATSHIKYAN",
"first_name": "ELMIRA",
"middle_name": "AMY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-03",
"last_updated": "2015-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "64596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2015; 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.