Active NPI
Naira Simonyan, DMD
- General Practice Dentistry
- Grapevine, TX
National Provider Identifier
1619965050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 30412
- Practice address
- 1015 W Wall St
Grapevine, TX 76051-5151 - Phone
- (817) 380-5241
- NPI assigned
- Oct 10, 2005
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 107281 | CA | |
| General Practice Dentistry | 1223G0001X | 019-026607 | IL | |
| General Practice Dentistry | 1223G0001X | 30412 | TX | Primary |
Addresses
Primary practice location
1015 W Wall St
Grapevine, TX 76051-5151
Mailing address
2155 Kettner Blvd Unit 312
San Diego, CA 92101-1747
Phone (312) 402-2072
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 |
|---|---|---|---|
| 107281 | CA | MD | General Practice Dentistry |
| 019-026607 | IL | MD | General Practice Dentistry |
| 30412 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775088000000",
"number": "1619965050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2155 KETTNER BLVD UNIT 312",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921011747",
"telephone_number": "312-402-2072",
"fax_number": "312-402-2072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 W WALL ST",
"city": "GRAPEVINE",
"state": "TX",
"postal_code": "760515151",
"telephone_number": "817-380-5241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMONYAN",
"first_name": "NAIRA",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-10-10",
"last_updated": "2026-04-02",
"certification_date": "2026-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "107281",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019-026607",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "30412",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grapevine, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.