Individual provider Active NPI

Yara Cathrina Arnouk, DDS

  • General Practice Dentistry
  • Glendora, CA
National Provider Identifier
1790358968
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
106626 Issued in CA
Practice address
210 S Grand Ave Ste 420
Glendora, CA 91741-4294
Phone
(626) 963-3322
NPI assigned
Jul 23, 2021
Last updated
Jul 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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 106626 CA Primary

Addresses

Primary practice location

210 S Grand Ave Ste 420
Glendora, CA 91741-4294

Mailing address

210 S Grand Ave Ste 420
Glendora, CA 91741-4294

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
I20211026000501 CA Practitioner - Oral Surgery 7911395868 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106626CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Arnouk DDS Inc General Practice CurrentSince Oct 15, 2021 Accepting new patients

Locations

210 S Grand Ave
Ste 420
Glendora, CA 91741
Phone (316) 300-8959

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": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1790358968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S GRAND AVE STE 420",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S GRAND AVE STE 420",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414294",
            "telephone_number": "626-963-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOUK",
        "first_name": "YARA",
        "middle_name": "CATHRINA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.