Active NPI
Ardalan Esakharian, DMD
- Dentist
- S Pasadena, CA
National Provider Identifier
1619644804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS107239
- Practice address
- 813 Fair Oaks Ave
S Pasadena, CA 91030-2605 - Phone
- (626) 593-0053
- NPI assigned
- Aug 25, 2021
- Sex
- Male
- 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 | DDS107239 | CA | Primary |
Addresses
Primary practice location
813 Fair Oaks Ave
S Pasadena, CA 91030-2605
Mailing address
1420 Rexford Dr Apt 5
Los Angeles, CA 90035-3154
Phone (310) 403-5945
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 |
|---|---|---|---|
| DDS107239 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martin Galstuan Dental Corporation | Dentist | Past | Accepting new patients |
| Gateway Dental Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dentist
- South Pasadena, CA
- NPI 1518319334
-
- General Practice Dentistry
- Hialeah, FL
- NPI 1396150199
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642636800000",
"number": "1619644804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1420 REXFORD DR APT 5",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900353154",
"telephone_number": "310-403-5945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "813 FAIR OAKS AVE",
"city": "S PASADENA",
"state": "CA",
"postal_code": "910302605",
"telephone_number": "626-593-0053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESAKHARIAN",
"first_name": "ARDALAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-25",
"last_updated": "2022-01-20",
"certification_date": "2022-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS107239",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in S Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.