Organization Active NPI

Town Center Dentistry

Doing business as esthetic dentistry

  • Dentist
  • Glendale, CA
National Provider Identifier
1639548050
Registry record updated Sep 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
50563 Issued in CA
Legal business name
TOWN CENTER DENTISTRY
Doing business as
esthetic dentistry
Practice address
1902 W Glenoaks Blvd
Glendale, CA 91201-1616
Phone
(818) 638-7200
NPI assigned
Sep 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2015

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

Authorized official

Name
Dr. Hamlet AvanesianNPI 1437260080
Title
DDS
Phone
(818) 548-7700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 50563 CA Primary

Addresses

Primary practice location

1902 W Glenoaks Blvd
Glendale, CA 91201-1616

Mailing address

316 E Broadway # a
Glendale, CA 91205-1011
Phone (818) 548-7700

Other identifiers 1

IdentifierTypeStateIssuer
G9338001OtherCADENTI-CAL

Other names 1

  • esthetic dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

316 E Broadway
#A
Glendale, CA 91205
Phone (818) 548-7700

1902 W Glenoaks Blvd
Glendale, CA 91201
Phone (818) 638-7200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442275200000",
    "number": "1639548050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 E BROADWAY # A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051011",
            "telephone_number": "818-548-7700",
            "fax_number": "818-548-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 W GLENOAKS BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912011616",
            "telephone_number": "818-638-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN CENTER DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-15",
        "last_updated": "2015-09-15",
        "status": "A",
        "authorized_official_last_name": "AVANESIAN",
        "authorized_official_first_name": "HAMLET",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "818-548-7700",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "50563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "G9338001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "esthetic dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 15, 2015; 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.