Individual provider Active NPI

Yerevan Movses Karagyozyan, DDS

  • General Practice Dentistry
  • Artesia, CA
National Provider Identifier
1790965119
Registry record updated Nov 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
55925 Issued in CA
Practice address
17700 Pioneer Blvd
Artesia, CA 90701-4011
Phone
(562) 865-0013
NPI assigned
Nov 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 55925 CA
General Practice Dentistry 1223G0001X 55925 CA Primary

Addresses

Primary practice location

17700 Pioneer Blvd
Artesia, CA 90701-4011

Mailing address

11430 Via Norte
Loma Linda, CA 92354-3839
Phone (626) 628-5961

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

LicenseStateTypeSpecialty
55925CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel R Maehara DDS Inc Dentist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226275200000",
    "number": "1790965119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11430 VIA NORTE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543839",
            "telephone_number": "626-628-5961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17700 PIONEER BLVD",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907014011",
            "telephone_number": "562-865-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARAGYOZYAN",
        "first_name": "YEREVAN",
        "middle_name": "MOVSES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-14",
        "last_updated": "2008-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "55925",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Artesia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.

Verify at the official NPI Registry.