Individual provider Active NPI

Michael Nazarian, D.D.S.

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1790084416
Registry record updated Mar 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
53250 Issued in CA
Practice address
10551 W Pico Blvd
2ND Floor
Los Angeles, CA 90064-2319
Phone
(310) 475-7336
NPI assigned
Mar 21, 2011
Last updated
Mar 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 53250 CA Primary

Addresses

Primary practice location

10551 W Pico Blvd
2ND Floor
Los Angeles, CA 90064-2319

Mailing address

10551 W Pico Blvd
2ND Floor
Los Angeles, CA 90064-2319
Phone (310) 475-7336

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

NPI Registry JSON

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300665600000",
    "number": "1790084416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10551 W PICO BLVD",
            "address_2": "2ND FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642319",
            "telephone_number": "310-475-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10551 W PICO BLVD",
            "address_2": "2ND FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642319",
            "telephone_number": "310-475-7336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZARIAN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-21",
        "last_updated": "2011-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53250",
            "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 21, 2011; 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.