Individual provider Active NPI

Janet Ajdaharian, DMD

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1437721701
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
108173 Issued in CA
Practice address
5101 Santa Monica Blvd Ste 15
Los Angeles, CA 90029-2481
Phone
(323) 665-5423
NPI assigned
Jul 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 108173 CA Primary

Addresses

Primary practice location

5101 Santa Monica Blvd Ste 15
Los Angeles, CA 90029-2481

Mailing address

5101 Santa Monica Blvd
Los Angeles, CA 90029-2478
Phone (323) 665-5423

Other practice location 1

5151 Hazeltine Ave
Sherman Oaks, CA 91423-1116
Phone (818) 724-5929

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
I20221027002695 CA Order and Referring Only - DentistPractitioner - Dentist 8729455167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
108173CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sherman Oaks Dental Arts PastSince Jun 15, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1437721701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 SANTA MONICA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900292478",
            "telephone_number": "323-665-5423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 SANTA MONICA BLVD STE 15",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900292481",
            "telephone_number": "323-665-5423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5151 Hazeltine Ave",
            "address_purpose": "LOCATION",
            "city": "Sherman Oaks",
            "state": "CA",
            "postal_code": "914231116",
            "country_code": "US",
            "telephone_number": "818-724-5929",
            "fax_number": "818-514-8960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AJDAHARIAN",
        "first_name": "JANET",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.