Individual provider Active NPI

Christina Ohanesian, D.D.S.

  • General Practice Dentistry
  • Upland, CA
National Provider Identifier
1699659870
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
111783 Issued in CA
Practice address
817 W Foothill Blvd
Upland, CA 91786-3727
Phone
(909) 657-1089
NPI assigned
Aug 1, 2025
Last updated
Aug 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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 111783 CA Primary

Addresses

Primary practice location

817 W Foothill Blvd
Upland, CA 91786-3727

Mailing address

2172 Baseline Rd
La Verne, CA 91750
Phone (909) 938-8017

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
I20250925000930 CA Order and Referring Only - DentistPractitioner - Dentist 1557866019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111783CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew Mikhail Dental Corporation General Practice CurrentSince Aug 3, 2025 Accepting new patients

Locations

817 W Foothill Blvd
Upland, CA 91786
Phone (909) 657-1089

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": "1754006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1699659870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2172 BASELINE RD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "91750",
            "telephone_number": "909-938-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 W FOOTHILL BLVD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863727",
            "telephone_number": "909-657-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHANESIAN",
        "first_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-01",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "111783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.