Individual provider Active NPI

Roger B Simonian, DDS

  • General Practice Dentistry
  • Fresno, CA
National Provider Identifier
1629132063
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23562CA Issued in CA
Practice address
7375 N Fresno St Ste 102
Fresno, CA 93720-2478
Phone
(559) 440-0876
Fax
(559) 440-0880
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 23562CA CA Primary

Addresses

Primary practice location

7375 N Fresno St Ste 102
Fresno, CA 93720-2478

Mailing address

7375 N Fresno St Ste 102
Fresno, CA 93720-2478
Phone (559) 440-0876

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

LicenseStateTypeSpecialty
23562CACAMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: roger.simonian.1@17661.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629132063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7375 N FRESNO ST STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202478",
            "telephone_number": "559-440-0876",
            "fax_number": "559-440-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7375 N FRESNO ST STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202478",
            "telephone_number": "559-440-0876",
            "fax_number": "559-440-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONIAN",
        "first_name": "ROGER",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "23562CA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.