Individual provider Active NPI

Mariya Grigoryan, D.D.S.

  • General Practice Dentistry
  • Visalia, CA
National Provider Identifier
1649323726
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
54144 Issued in CA
Practice address
2634 W Walnut Ave
Visalia, CA 93277-4378
Phone
(559) 732-7224
Fax
(559) 732-7226
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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 54144 CA Primary

Addresses

Primary practice location

2634 W Walnut Ave
Visalia, CA 93277-4378

Mailing address

2634 W Walnut Ave
1
Visalia, CA 93277-4378
Phone (559) 732-7224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110919000774 CA Practitioner - Oral SurgeryPractitioner - Dentist 4880865047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Crest Home Health Current Accepting new patients
Mariya Grigoryan DDS Inc General Practice CurrentSince Jan 1, 2007 Accepting new patients

Locations

2634 W Walnut Ave
#1
Visalia, CA 93277

2634 W Walnut Ave
Visalia, CA 93277
Phone (559) 732-7224

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1649323726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2634 W WALNUT AVE",
            "address_2": "1",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932774378",
            "telephone_number": "559-732-7224",
            "fax_number": "559-732-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2634 W WALNUT AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932774378",
            "telephone_number": "559-732-7224",
            "fax_number": "559-732-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIGORYAN",
        "first_name": "MARIYA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.