Active NPI
Edvin Agadzhanov, D.D.S.
- General Practice Dentistry
- Santa Barbara, CA
National Provider Identifier
1780848887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 57233
- Practice address
- 923 N Milpas St
Santa Barbara, CA 93103-2331 - Phone
- (805) 884-1998
- NPI assigned
- Jul 17, 2008
- Last updated
- Jul 21, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 57233 | CA | Primary |
Addresses
Primary practice location
923 N Milpas St
Santa Barbara, CA 93103-2331
Mailing address
19231 Sherman Way #23
Reseda, CA 91335
Phone (818) 344-1723
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57233 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edvin Agadzhanov DDS Inc | General Practice | Past | Accepting new patients |
| Santa Barbara Neighborhood Clinics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Canyon Country, CA
- NPI 1356655765
-
dba Eastside Family Dental Clinic
- Dental Clinic/Center
- Santa Barbara, CA
- NPI 1972636835
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216598400000",
"number": "1780848887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19231 SHERMAN WAY #23",
"city": "RESEDA",
"state": "CA",
"postal_code": "91335",
"telephone_number": "818-344-1723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "923 N MILPAS ST",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931032331",
"telephone_number": "805-884-1998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGADZHANOV",
"first_name": "EDVIN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-17",
"last_updated": "2008-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "57233",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Barbara, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.