Active NPI
Hamlet S. Avanesian, DDS
- Dentist
- Glendale, CA
National Provider Identifier
1437260080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 50563
- Practice address
- 316 E Broadway
Suite a
Glendale, CA 91205-1011 - Phone
- (818) 548-7700
- Fax
- (818) 548-7697
- NPI assigned
- Aug 31, 2006
- Last updated
- Mar 19, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 50563 | CA | Primary |
| General Practice Dentistry | 1223G0001X | 50563 | CA |
Addresses
Primary practice location
316 E Broadway
Suite a
Glendale, CA 91205-1011
Mailing address
316 E Broadway
Suite a
Glendale, CA 91205-1011
Phone (818) 548-7700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C-9338001 | Medicaid | CA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50563 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Town Center Dentistry | Dentist | Past | Accepting new patients |
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": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268956800000",
"number": "1437260080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "316 E BROADWAY",
"address_2": "SUITE A",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912051011",
"telephone_number": "818-548-7700",
"fax_number": "818-548-7697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 E BROADWAY",
"address_2": "SUITE A",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912051011",
"telephone_number": "818-548-7700",
"fax_number": "818-548-7697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVANESIAN",
"first_name": "HAMLET",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2010-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "50563",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "50563",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "C-9338001",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.