Active NPI
Marianna Abrahamyan
- Dentist
- La Quinta, CA
National Provider Identifier
1639944283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 109704
- Practice address
- 78080 Avenida la Fonda
La Quinta, CA 92253-2923 - Phone
- (760) 777-9127
- NPI assigned
- Nov 22, 2023
- Last updated
- Mar 12, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 109704 | CA | Primary |
Addresses
Primary practice location
78080 Avenida la Fonda
La Quinta, CA 92253-2923
Mailing address
39529 Camino Sabroso
Indio, CA 92203-4373
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240524000004 | WA | Order and Referring Only - Oral Surgery | 6800238668 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109704 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773273600000",
"number": "1639944283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39529 CAMINO SABROSO",
"city": "INDIO",
"state": "CA",
"postal_code": "922034373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "78080 AVENIDA LA FONDA",
"city": "LA QUINTA",
"state": "CA",
"postal_code": "922532923",
"telephone_number": "760-777-9127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABRAHAMYAN",
"first_name": "MARIANNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-11-22",
"last_updated": "2026-03-12",
"certification_date": "2026-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "109704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Quinta, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.