Vram Jeannot Kargodorian, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

39820 Issued in CA

Practice address

11200 Corbin Ave
#100
Porter Ranch, CA 91326-4120

Phone

(818) 832-6000

Fax

(818) 832-7191

NPI assigned

Jan 10, 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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 24, 2021 through Sep 24, 2027

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1356491864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11200 CORBIN AVE",
            "address_2": "#100",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913264120",
            "telephone_number": "818-832-6000",
            "fax_number": "818-832-7191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 CORBIN AVE",
            "address_2": "#100",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913264120",
            "telephone_number": "818-832-6000",
            "fax_number": "818-832-7191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARGODORIAN",
        "first_name": "VRAM",
        "middle_name": "JEANNOT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Menanno LMFT
• Samar Kadi, CRTT
• Kaiser Foundation Health Plan Inc
• Dina Mabel Kancepolsky
• Razmig Alain Karageuzian
• Samantha Camille De la Cruz Kasingsing, NP
• Nebila Kasse, PHARMD.
• Hardeep Kaur Kataria, O.D
• Mariella Keating, NP
• Gerie Keh, L.AC.

• General Practice Dentistry in Porter Ranch, CA
• Providers in Porter Ranch, 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 Jan 18, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.