Antranig Gary Kelleyan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

52409 Issued in CA

Practice address

616 N Garfield Ave
St 404
Monterey Park, CA 91754-1141

Phone

(626) 280-4122

Fax

(626) 280-4124

NPI assigned

Aug 8, 2006

Last updated

Apr 29, 2011By 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 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

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.

• Antranig Gary Kelleyan DDS Inc.

  • General Practice Dentistry
  • Monterey Park, CA
  • NPI 1801035381
  NPD (past) Authorized official
• Gary Leeling DDS, Inc.

  • General Practice Dentistry
  • Monterey Park, CA
  • NPI 1023159183
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304035200000",
    "number": "1568472991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 N GARFIELD AVE",
            "address_2": "SUITE # 404",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541141",
            "telephone_number": "626-280-4122",
            "fax_number": "626-280-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 N GARFIELD AVE",
            "address_2": "ST 404",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541141",
            "telephone_number": "626-280-4122",
            "fax_number": "626-280-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEYAN",
        "first_name": "ANTRANIG",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2011-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hone Soo Kaw, M.D
• Irvin Kaw, DMD
• Phillip Z Kaw
• Kaygo Consultants
• KC Tan, M.D. Medical Corporation
• Kelly Wong DO Inc
• Kelvin H Nguyen Foot & Ankle Corporation
• Shiun T Ker, M.D.
• Kevin H. Tseng, D.P.M.
• Kevin Trong Nguyen DO Inc

• General Practice Dentistry in Monterey Park, CA
• Providers in Monterey Park, 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 Apr 29, 2011; 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.