Individual provider Active NPI

Gurgen Sahakyan, D.D.S.

  • General Practice Dentistry
  • Glendale, CA
National Provider Identifier
1497985618
Registry record updated May 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
58472 Issued in CA
Practice address
501 W Glenoaks Blvd Ste 204
Glendale, CA 91202-4043
Phone
(818) 390-4315
NPI assigned
Jul 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 58472 CA Primary

Addresses

Primary practice location

501 W Glenoaks Blvd Ste 204
Glendale, CA 91202-4043

Mailing address

501 W Glenoaks Blvd Ste 204
Glendale, CA 91202-4043
Phone (818) 390-4315

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
I20201231000946 CA Practitioner - Dentist 3072926443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
58472CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sahakyan, DDS, Inc. General Practice CurrentSince Sep 10, 2020 Accepting new patients

Locations

3808 W Riverside Dr
Ste 502
Burbank, CA 91505
Phone (818) 843-8476

501 W Glenoaks Blvd
Ste 204
Glendale, CA 91202
Phone (818) 244-0004

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": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1497985618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W GLENOAKS BLVD STE 204",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912024043",
            "telephone_number": "818-390-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W GLENOAKS BLVD STE 204",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912024043",
            "telephone_number": "818-390-4315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAHAKYAN",
        "first_name": "GURGEN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-22",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.