Gurgen Abazyan, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

108101 Issued in CA

Practice address

4325 Lauderdale Ave
La Crescenta, CA 91214-2461

Phone

(818) 699-3391

NPI assigned

Sep 21, 2022

Last updated

Sep 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Gurgen Abazyan, D.M.D, Inc.

  • General Practice Dentistry
  • Simi Valley, CA
  • NPI 1528927118
  NPD Authorized official
• Gurgen Abazyan, D.M.D, Inc.

  • General Practice Dentistry
  • Simi Valley, CA
  • NPI 1912872979
  NPD Authorized official

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1710600101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 LAUDERDALE AVE",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912142461",
            "telephone_number": "818-699-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 LAUDERDALE AVE",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912142461",
            "telephone_number": "818-699-3391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABAZYAN",
        "first_name": "GURGEN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "108101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in La Crescenta, CA
• Providers in La Crescenta, 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 Sep 21, 2022; 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.