NPIMap

Organization Active NPI

Ankin Deragobian D.D.S. Inc.

  • Exclusive Provider Organization
  • Rancho Cucamonga, CA
National Provider Identifier
1376942672
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
59757 Issued in CA
Legal business name
ANKIN DERAGOBIAN D.D.S. INC.
Practice address
9635 Milliken Ave Ste 103
Rancho Cucamonga, CA 91730-9004
Phone
(909) 481-8990
Fax
(909) 481-8875
NPI assigned
Aug 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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

Authorized official

Name
Dr. Ankin Deragobian, DDSNPI 1467760041
Title
Owner/President
Phone
(909) 481-8990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 59757 CA Primary

Addresses

Primary practice location

9635 Milliken Ave Ste 103
Rancho Cucamonga, CA 91730-9004

Mailing address

9635 Milliken Ave Ste 103
Rancho Cucamonga, CA 91730-9004
Phone (909) 481-8990

Other names 1

  • Golden Smiles Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422403200000",
    "number": "1376942672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9635 MILLIKEN AVE STE 103",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917309004",
            "telephone_number": "909-481-8990",
            "fax_number": "909-481-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9635 MILLIKEN AVE STE 103",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917309004",
            "telephone_number": "909-481-8990",
            "fax_number": "909-481-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANKIN DERAGOBIAN D.D.S. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-22",
        "last_updated": "2015-01-28",
        "status": "A",
        "authorized_official_last_name": "DERAGOBIAN",
        "authorized_official_first_name": "ANKIN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "909-481-8990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CA",
            "license": "59757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden Smiles Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.