Active NPI
Rita T Deragobian, DDS
- Dentist
- Montclair, CA
National Provider Identifier
1578742953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 55480
- Practice address
- 9509 Central Ave. Suite # D
Montclair, CA 91763 - Phone
- (909) 399-3330
- NPI assigned
- Nov 1, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 55480 | CA | Primary |
Addresses
Primary practice location
9509 Central Ave. Suite # D
Montclair, CA 91763
Mailing address
9509 Central Ave Ste D
Montclair, CA 91763-2400
Phone (909) 399-3330
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rita Deragobian DDS Inc | Dentist | Past | Accepting new patients |
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": "1193875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578441600000",
"number": "1578742953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9509 CENTRAL AVE STE D",
"city": "MONTCLAIR",
"state": "CA",
"postal_code": "917632400",
"telephone_number": "909-399-3330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9509 CENTRAL AVE. SUITE # D",
"city": "MONTCLAIR",
"state": "CA",
"postal_code": "91763",
"telephone_number": "909-399-3330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERAGOBIAN",
"first_name": "RITA",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-01",
"last_updated": "2020-01-08",
"certification_date": "2020-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "55480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.