Individual provider Active NPI

Roza Poghosyan, DDS

  • General Practice Dentistry
  • San Francisco, CA
National Provider Identifier
1699250837
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
102642 Issued in CA
Practice address
2713 44TH Ave Apt 5
San Francisco, CA 94116-2641
Phone
(415) 971-3384
NPI assigned
Oct 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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 102642 CA Primary

Addresses

Primary practice location

2713 44TH Ave Apt 5
San Francisco, CA 94116-2641

Mailing address

2713 44TH Ave Apt 5
San Francisco, CA 94116-2641
Phone (415) 971-3384

Other practice location 1

2713 44th Ave Apt 5
San Francisco, CA 94116-2641
Phone (415) 971-3384

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
I20230321001196 CA Order and Referring Only - DentistPractitioner - Dentist 8628442340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1699250837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2713 44TH AVE APT 5",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162641",
            "telephone_number": "415-971-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2713 44TH AVE APT 5",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162641",
            "telephone_number": "415-971-3384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2713 44th Ave Apt 5",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941162641",
            "country_code": "US",
            "telephone_number": "415-971-3384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POGHOSYAN",
        "first_name": "ROZA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "102642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.