Individual provider Active NPI

Zara Petrosyan

  • General Practice Dentistry
  • Berkeley, CA
National Provider Identifier
1417874512
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
113259 Issued in CA
Practice address
1760 Solano Ave Ste 309
Berkeley, CA 94707-2218
Phone
(510) 527-9564
NPI assigned
Jul 1, 2026
Last updated
Jul 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 113259 CA
General Practice Dentistry 1223G0001X 113259 CA Primary

Addresses

Primary practice location

1760 Solano Ave Ste 309
Berkeley, CA 94707-2218

Mailing address

199 New Montgomery St Unit 607
San Francisco, CA 94105-3804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1782864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1417874512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 NEW MONTGOMERY ST UNIT 607",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941053804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 SOLANO AVE STE 309",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947072218",
            "telephone_number": "510-527-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSYAN",
        "first_name": "ZARA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-01",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "113259",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "113259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; 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.