Individual provider Active NPI

Armond Kotikian, M.D., DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Glendale, CA
National Provider Identifier
1396868774
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
49568 Issued in CA
Practice address
242 N. Glendale Ave
Glendale, CA 91206
Phone
(818) 484-8939
NPI assigned
Apr 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 49568 CA Primary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 106145 CA
Student in an Organized Health Care Education/Training Program 390200000X 4301086538 MI

Addresses

Primary practice location

242 N. Glendale Ave
Glendale, CA 91206

Mailing address

242 N Glendale Ave
Glendale, CA 91206-4454
Phone (818) 484-8939

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090515000128 CA Practitioner - Oral SurgeryPractitioner - OtolaryngologyPractitioner - AnesthesiologyPractitioner - Plastic and Reconstructive SurgeryPractitioner - Maxillofacial SurgeryPractitioner - Surgical Oncology 9335298611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Anesthesiology, Maxillofacial Surgery, Otolaryngology, Plastic and Reconstructive Surgery
Education
University of California, Geffen School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Garabedian and Kotikian Dental CorporationGroup PAC ID 3577714195, 2 clinicians

Practice addresses (Care Compare)

242 N Glendale Ave
Glendale, CA 91206-4454
Phone (818) 484-8939

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
106145CAMDGeneral Practice Dentistry
4301086538MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Garabedian and Kotikian Dental Corporation CurrentSince Aug 26, 2012 Accepting new patients

Locations

242 N Glendale Ave
Glendale, CA 91206
Phone (818) 409-0925

242 N Glendale Ave
#M
Glendale, CA 91206

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1396868774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 N GLENDALE AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064454",
            "telephone_number": "818-484-8939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 N. GLENDALE AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91206",
            "telephone_number": "818-484-8939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTIKIAN",
        "first_name": "ARMOND",
        "credential": "M.D., DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "49568",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "106145",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301086538",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.