Organization Active NPI

Shahgaldian Professional Dental Corp

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1710358726
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
59269 Issued in CA
Legal business name
SHAHGALDIAN PROFESSIONAL DENTAL CORP
Practice address
279 S Atlantic Blvd
Ste # B
Los Angeles, CA 90022-1734
Phone
(818) 523-7626
NPI assigned
Oct 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Authorized official

Name
Dr. Christine Shahgaldian
Title
Dentist/Owner
Phone
(818) 523-7626

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 59269 CA Primary

Addresses

Primary practice location

279 S Atlantic Blvd
Ste # B
Los Angeles, CA 90022-1734

Mailing address

279 S Atlantic Blvd
Ste # B
Los Angeles, CA 90022-1734

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1444953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1710358726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 S ATLANTIC BLVD",
            "address_2": "STE # B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 S ATLANTIC BLVD",
            "address_2": "STE # B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221734",
            "telephone_number": "818-523-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHGALDIAN PROFESSIONAL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-16",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "SHAHGALDIAN",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "818-523-7626",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "59269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.