Individual provider Active NPI

Nathan A Nourian, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Panorama City, CA
National Provider Identifier
1679175871
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DDS105373 Issued in CA
Practice address
8424 Van Nuys Blvd
Panorama City, CA 91402-3610
Phone
(818) 986-7531
NPI assigned
Nov 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS105373 CA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DDS105373 CA Primary

Addresses

Primary practice location

8424 Van Nuys Blvd
Panorama City, CA 91402-3610

Mailing address

8424 Van Nuys Blvd
Van Nuys, CA 91402-3610
Phone (818) 893-4222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20221111002006 GA Order and Referring Only - DentistPractitioner - Dentist 6709253222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS105373CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nourian Dental Inc. CurrentSince Sep 10, 2023 Accepting new patients
Nourian Dental Group, Inc. Dentist CurrentSince Aug 13, 2023 Accepting new patients

Locations

8424 Van Nuys Blvd
Van Nuys, CA 91402
Phone (818) 893-4222

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": "1605139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1679175871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8424 VAN NUYS BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914023610",
            "telephone_number": "818-893-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8424 VAN NUYS BLVD",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914023610",
            "telephone_number": "818-986-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOURIAN",
        "first_name": "NATHAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-12",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS105373",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "DDS105373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panorama City, CA

Sources for this page

Verify at the official NPI Registry.