Rupen Derboghosian Itutmazian, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

55226 Issued in CA

Practice address

6812 Woodman Ave
Van Nuys, CA 91405-4208

Phone

(818) 350-3451

NPI assigned

Dec 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1699831065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 PONCETTA DR APT 327",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940154810",
            "telephone_number": "818-350-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6812 WOODMAN AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054208",
            "telephone_number": "818-350-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERBOGHOSIAN ITUTMAZIAN",
        "first_name": "RUPEN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55226",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "5411",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "RI",
            "license": "CDEN03106",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NH",
            "license": "03895",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lea Dennis, MFT
• Brianne Depusoy
• Bernadette Derakhshan
• Liz Deras
• Hakop Derbeshyan, D.C.
• Elizabeth Derboghosian, DDS
• Roberto Derboghosian, DDS
• Robin Derose, OTR,CHT,CVE
• Brittany Dery
• Deryl Goldenberg a Psychological Corp.

• General Practice Dentistry in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.