Antranig Gary Kelleyan DDS Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

52409 Issued in CA

Legal business name

ANTRANIG GARY KELLEYAN DDS INC.

Practice address

616 N Garfield Ave Ste 404
Monterey Park, CA 91754-1101

Phone

(626) 280-4122

Fax

(626) 280-4124

NPI assigned

Feb 6, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Antranig Gary KelleyanNPI 1568472991

Title

Ceo

Phone

(626) 280-4122

Specialties & licenses 1

Addresses

Tax ID family

Antranig Gary Kelleyan DDS Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Antranig Kelleyan

  • General Practice Dentistry
  • Baldwin Park, CA
  • NPI 1659653970
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Antranig Gary Kelleyan, D.D.S.

  • General Practice Dentistry
  • Monterey Park, CA
  • NPI 1568472991
  NPD (past) Authorized official

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

{
    "created_epoch": "1233878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233878400000",
    "number": "1801035381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 N GARFIELD AVE STE 404",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541101",
            "telephone_number": "626-280-4122",
            "fax_number": "626-280-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 N GARFIELD AVE STE 404",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541101",
            "telephone_number": "626-280-4122",
            "fax_number": "626-280-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTRANIG GARY KELLEYAN DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-06",
        "last_updated": "2009-02-06",
        "status": "A",
        "authorized_official_last_name": "KELLEYAN",
        "authorized_official_first_name": "ANTRANIG",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-280-4122",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Monterey Park, CA
• Providers in Monterey Park, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2009; 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.