Ankin Deragobian, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

59757 Issued in CA

Practice address

25997 Lawton Ave
Loma Linda, CA 92354

Phone

(909) 747-4861

NPI assigned

Sep 17, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

State licenses

Practice roles

Locations

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.

• Ankin Deragobian D.D.S. Inc.

  dba Golden Smiles Dental

  • Exclusive Provider Organization
  • Rancho Cucamonga, CA
  • NPI 1376942672
  NPD Authorized official

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

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284681600000",
    "number": "1467760041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25997 LAWTON AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25997 LAWTON AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92354",
            "telephone_number": "909-747-4861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERAGOBIAN",
        "first_name": "ANKIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-17",
        "last_updated": "2010-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mega Maninder Deol, NP
• Bener Joseph Deompoc Jr.
• Allison Depas, MD
• Nicole Lauren Depolo, MD
• Linda Deppe, D.O.
• Aram Tertat Deragobian, DDS
• Adeeb Derakhshan
• Apra Desai, PHARM D.
• Kinnari Ishvar Desai, DO
• Jade Ariane Deschamps-Stutzman, MD

• General Practice Dentistry in Loma Linda, CA
• Providers in Loma Linda, 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 Sep 17, 2010; 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.