Active NPI
Sisian Yaghoubi
- Dentist
- La Crescenta, CA
National Provider Identifier
1538056197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 111698
- Practice address
- 3904 Foothill Blvd
La Crescenta, CA 91214-1620 - Phone
- (818) 350-8182
- NPI assigned
- Jun 18, 2025
- Last updated
- Jun 18, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 111698 | CA | Primary |
Addresses
Primary practice location
3904 Foothill Blvd
La Crescenta, CA 91214-1620
Mailing address
9928 Pali Ave
Tujunga, CA 91042-2941
Phone (818) 524-0778
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111698 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750204800000",
"number": "1538056197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9928 PALI AVE",
"city": "TUJUNGA",
"state": "CA",
"postal_code": "910422941",
"telephone_number": "818-524-0778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3904 FOOTHILL BLVD",
"city": "LA CRESCENTA",
"state": "CA",
"postal_code": "912141620",
"telephone_number": "818-350-8182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAGHOUBI",
"first_name": "SISIAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-06-18",
"last_updated": "2025-06-18",
"certification_date": "2025-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "111698",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Crescenta, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.