Individual provider Active NPI

Harry Harapet Elyassi, DMD

  • Dentist
  • Glendale, CA
National Provider Identifier
1376992586
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
100246 Issued in CA
Practice address
221 E Glenoaks Blvd Ste 210
Glendale, CA 91207-2165
Phone
(818) 296-9660
Fax
(818) 296-9075
NPI assigned
Jun 8, 2016
Last updated
Nov 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 100246 CA Primary

Addresses

Primary practice location

221 E Glenoaks Blvd Ste 210
Glendale, CA 91207-2165

Mailing address

600 W Broadway Ste 120
Glendale, CA 91204-1023
Phone (818) 926-8284

Other practice location 1

600 W Broadway Ste 120
Glendale, CA 91204-1023
Phone (818) 409-0924

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
I20170327001371 CA Order and Referring Only - DentistPractitioner - Dentist 4981989340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100246CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Harry H. Elyassi, D.M.D., Inc. CurrentSince Nov 17, 2019 Accepting new patients

Locations

221 E Glenoaks Blvd
Ste 210
Glendale, CA 91207
Phone (818) 247-4444

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1376992586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W BROADWAY STE 120",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041023",
            "telephone_number": "818-926-8284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E GLENOAKS BLVD STE 210",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912072165",
            "telephone_number": "818-296-9660",
            "fax_number": "818-296-9075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 W Broadway Ste 120",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912041023",
            "country_code": "US",
            "telephone_number": "818-409-0924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELYASSI",
        "first_name": "HARRY",
        "middle_name": "HARAPET",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-08",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.