K. Shagramanova Dental Corp.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

K. SHAGRAMANOVA DENTAL CORP.

Practice address

3175 Firestone Blvd # 201
South Gate, CA 90280-2951

Phone

(323) 749-0137

Fax

(323) 749-0334

NPI assigned

May 28, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Kristina Shagramanova, DDSNPI 1871533760

Title

Ceo

Phone

(818) 636-9208

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 2

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

• Kristina Shagramanova

  • Endodontics
  • Glendale, CA
  • NPI 1871533760
  NPD (past) Authorized official
• Victor Manuel Moncada

  • Marriage & Family Therapist
  • Los Angeles, CA
  • NPI 1730969320
  NPD

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559001600000",
    "number": "1659938470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W COLORADO ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041504",
            "telephone_number": "818-956-9907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 FIRESTONE BLVD # 201",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902802951",
            "telephone_number": "323-749-0137",
            "fax_number": "323-749-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K. SHAGRAMANOVA DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-28",
        "last_updated": "2019-05-28",
        "status": "A",
        "authorized_official_last_name": "SHAGRAMANOVA",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-636-9208",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "lasmilesspecialtycenter.com",
            "affiliation": "N",
            "endpointDescription": "web portal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3175 Firestone Blvd # 201",
            "city": "South Gate",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902802951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christopher Michael Johnston
• Richard Jordan, M.D.
• Jorge Carreon, M.D., Inc.
• Joshua B. Novinbakht, DDS Inc.
• Joshua Jordan Medical Corporation
• Rana Rushdi Kaleel, DDS
• Kamila Comprehensive Health Center, Inc.
• Kamila Comprehensive Health Center, Inc.
• Kamran Sahabi D.D.S., a Professional Dental Corporation
• Nahyun Kang

• Endodontics in South Gate, CA
• Providers in South Gate, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; 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.