Individual provider Active NPI

Victoria Mouradian, DMD

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1659710432
Registry record updated Jun 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
62435 Issued in CA
Practice address
4905 Hollywood Blvd
Los Angeles, CA 90027-6101
Phone
(323) 461-9942
NPI assigned
Jun 14, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2013

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 62435 CA Primary

Addresses

Primary practice location

4905 Hollywood Blvd
Los Angeles, CA 90027-6101

Mailing address

519 South St
Apt 106
Glendale, CA 91202-2282
Phone (323) 807-2527

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
62435CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371168000000",
    "number": "1659710432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 SOUTH ST",
            "address_2": "APT 106",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022282",
            "telephone_number": "323-807-2527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 HOLLYWOOD BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276101",
            "telephone_number": "323-461-9942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURADIAN",
        "first_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2013-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "62435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2013; 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.