NPIMap

Organization Active NPI

Edmondbedrossian DDS, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • San Francisco, CA
National Provider Identifier
1821110446
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
034671 Issued in CA
Legal business name
EDMONDBEDROSSIAN DDS, INC.
Practice address
450 Sutter St
Suite 2439
San Francisco, CA 94108-4206
Phone
(415) 956-6610
Fax
(415) 956-6618
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Edmond Bedrossian, DDSNPI 1508988106
Title
President
Phone
(415) 956-6610

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 034671 CA Primary

Addresses

Primary practice location

450 Sutter St
Suite 2439
San Francisco, CA 94108-4206

Mailing address

450 Sutter St
Suite 2439
San Francisco, CA 94108-4206
Phone (415) 956-6610

Other identifiers 1

IdentifierTypeStateIssuer
655657OtherCAUNITED CONCORDIA

National Provider Directory

National Provider Directory

Locations

450 Sutter St
Rm 2439
San Francisco, CA 94108
Phone (415) 956-6610

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821110446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 SUTTER ST",
            "address_2": "SUITE 2439",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941084206",
            "telephone_number": "415-956-6610",
            "fax_number": "415-956-6618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 SUTTER ST",
            "address_2": "SUITE 2439",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941084206",
            "telephone_number": "415-956-6610",
            "fax_number": "415-956-6618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMONDBEDROSSIAN DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEDROSSIAN",
        "authorized_official_first_name": "EDMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-956-6610",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "034671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "655657",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.