Individual provider Active NPI

Alex Vartanian, DMD

  • Dentist
  • Pasadena, CA
National Provider Identifier
1710876438
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS111677 Issued in CA
Practice address
240 S Lake Ave
Pasadena, CA 91101-3002
Phone
(626) 765-3527
NPI assigned
Jun 30, 2025
Last updated
Jun 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS111677 CA Primary

Addresses

Primary practice location

240 S Lake Ave
Pasadena, CA 91101-3002

Mailing address

240 S Lake Ave
Pasadena, CA 91101-3002

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
I20250924004290 CA Order and Referring Only - DentistPractitioner - Dentist 9739684333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS111677CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Galstyan, D.D.S., Inc. CurrentSince Jul 9, 2025 Accepting new patients

Locations

240 S Lake Ave
Pasadena, CA 91101
Phone (626) 765-3527

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": "1751241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1710876438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 S LAKE AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911013002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 S LAKE AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911013002",
            "telephone_number": "626-765-3527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARTANIAN",
        "first_name": "ALEX",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS111677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.