Tevan Oganesyan, DDS, MS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

58366 Issued in CA

Practice address

1419 Superior Ave
#6
Newport Beach, CA 92663

Phone

(949) 646-4300

NPI assigned

Sep 17, 2010

Last updated

Jun 5, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Tevan Oganesyan DDS Inc. California Professional Corporation

  • General Practice Dentistry
  • Tarzana, CA
  • NPI 1336935949
  NPD Authorized official
• Oganesyan Dental Corporation

  • Dentist
  • Glendale, CA
  • NPI 1407204522
  Authorized official Same address or phone

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

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1457669046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 SUPERIOR AVE",
            "address_2": "#6",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926632723",
            "telephone_number": "949-646-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 SUPERIOR AVE",
            "address_2": "#6",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92663",
            "telephone_number": "949-646-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGANESYAN",
        "first_name": "TEVAN",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-17",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D7804",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oceans Sober Living
• Kimberly Ochoa
• Nicholas Bruce Oconnor, DC
• Ocpsychiatrist Inc.
• Stephanie Oderoha
• Brian Oh
• Bryan C Oh, M.D.
• Chung Oh
• Connie Oh, MD
• Frances Oh, M.S., L.C.G.C.

• General Practice Dentistry in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.