Individual provider Active NPI

Viken Leon Garabedian, DDS

  • Dentist
  • Laguna Niguel, CA
National Provider Identifier
1356549166
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
034332 Issued in CA
Practice address
30092 Ivy Glenn Dr
Suite 250
Laguna Niguel, CA 92677-5027
Phone
(949) 350-0507
NPI assigned
Jul 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 034332 CA Primary

Addresses

Primary practice location

30092 Ivy Glenn Dr
Suite 250
Laguna Niguel, CA 92677-5027

Mailing address

30092 Ivy Glenn Dr
Suite 250
Laguna Niguel, CA 92677-5027
Phone (949) 350-0507

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160601002556 CA Order and Referring Only - Oral SurgeryPractitioner - Oral SurgeryPractitioner - Orthopedic Surgery 4587954672

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
034332CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1356549166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30092 IVY GLENN DR",
            "address_2": "SUITE 250",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926775027",
            "telephone_number": "949-350-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30092 IVY GLENN DR",
            "address_2": "SUITE 250",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926775027",
            "telephone_number": "949-350-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARABEDIAN",
        "first_name": "VIKEN",
        "middle_name": "LEON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "034332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Niguel, CA

Sources for this page

Verify at the official NPI Registry.