Individual provider Active NPI

Miganoush Ghookasian, D.D.S.

  • Dentist
  • Sherman Oaks, CA
National Provider Identifier
1659791838
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
61539 Issued in CA
Practice address
5151 Hazeltine Ave
Sherman Oaks, CA 91423-1116
Phone
(818) 724-5929
NPI assigned
Apr 25, 2014
Last updated
Jun 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 61539 CA Primary

Addresses

Primary practice location

5151 Hazeltine Ave
Sherman Oaks, CA 91423-1116

Mailing address

1410 N Garey Ave
Suite B
Pomona, CA 91767-3810

Other practice location 1

1410 N Garey Ave
Suite B
Pomona, CA 91767-3810
Phone (818) 439-1709

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
61539CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sherman Oaks Dental Arts CurrentSince Jun 15, 2021 Accepting new patients

Locations

5151 Hazeltine Ave
Sherman Oaks, CA 91423
Phone (818) 724-5929

Organizations & group practices 1

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": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1659791838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 N GAREY AVE",
            "address_2": "SUITE B",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 HAZELTINE AVE",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914231116",
            "telephone_number": "818-724-5929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1410 N Garey Ave",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917673810",
            "country_code": "US",
            "telephone_number": "818-439-1709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHOOKASIAN",
        "first_name": "MIGANOUSH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-25",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "61539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.