Individual provider Active NPI

Edwin Babadjanian

  • Endodontics
  • Glendale, CA
National Provider Identifier
1629282611
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DDS59108 Issued in CA
Practice address
1101 N Pacific Ave Ste 206
Glendale, CA 91202-4367
Phone
(818) 548-5544
NPI assigned
May 9, 2007
Last updated
Jul 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS59108 CA
Endodontics 1223E0200X DDS59108 CA Primary
General Practice Dentistry 1223G0001X 052912 NY

Addresses

Primary practice location

1101 N Pacific Ave Ste 206
Glendale, CA 91202-4367

Mailing address

1101 N Pacific Ave Ste 206
Glendale, CA 91202-4367
Phone (818) 548-5544

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

State licenses

LicenseStateTypeSpecialty
DDS59108CAMDDentist
052912NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
North Glen Chiropractic, a Professional Corporation PastSince May 23, 2011 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1629282611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N PACIFIC AVE STE 206",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912024367",
            "telephone_number": "818-548-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N PACIFIC AVE STE 206",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912024367",
            "telephone_number": "818-548-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABADJANIAN",
        "first_name": "EDWIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS59108",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "DDS59108",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052912",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; 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.