NPIMap

Organization Active NPI

Smile Dental Practice

  • Dentist
  • Glendale, CA
National Provider Identifier
1508049842
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
43966 Issued in CA
Legal business name
SMILE DENTAL PRACTICE
Practice address
1114 E Broadway
Glendale, CA 91205-1316
Phone
(818) 500-7740
Fax
(818) 500-7754
NPI assigned
Dec 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Authorized official

Name
Dr. Edik Haghverdian, D.D.SNPI 1578779401
Title
Dentist
Phone
(818) 500-7740

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 43966 CA Primary

Addresses

Primary practice location

1114 E Broadway
Glendale, CA 91205-1316

Mailing address

1114 E Broadway
Glendale, CA 91205-1316
Phone (818) 500-7740

National Provider Directory

National Provider Directory

Locations

1114 E Broadway
Glendale, CA 91205
Phone (818) 500-7740

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1508049842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 E BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051316",
            "telephone_number": "818-500-7740",
            "fax_number": "818-500-7754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 E BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051316",
            "telephone_number": "818-500-7740",
            "fax_number": "818-500-7754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE DENTAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-10",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "HAGHVERDIAN",
        "authorized_official_first_name": "EDIK",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "818-500-7740",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "43966",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.