Katya Archambault, DMD

Primary specialty

Oral and Maxillofacial Radiology DentistryTaxonomy code 1223X0008X

License

DDS65278 Issued in CA

Practice address

9245 Regents Rd Unit M208
La Jolla, CA 92037-9266

Phone

(310) 307-6623

NPI assigned

Jan 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Oral Surgery

Education

Univ of Calif, Los Angeles School of Dentistry, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• San Diego Dental Health Center LLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • La Jolla, CA
  • NPI 1386289478
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1700350485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9245 REGENTS RD UNIT M208",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920379266",
            "telephone_number": "310-307-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9245 REGENTS RD UNIT M208",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920379266",
            "telephone_number": "310-307-6623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHAMBAULT",
        "first_name": "KATYA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-16",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "CA",
            "license": "DDS65278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Antkowiak
• Arash Khatami MD Inc
• Alba Racheal Araujo
• Nasrin Arbabi
• Christian Francis Archambault, MD
• Solana Rose Archuleta, MD
• Edward Guisande Arevalo, M.D.
• Shilpa Pramod Argade, MD
• Babak Ariannejad, DMD
• Shahab Ariannejad, D.M.D.

• Dentist in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.