Individual provider Active NPI

Leonis Nazaryan, DDS

  • General Practice Dentistry
  • Glendale, CA
National Provider Identifier
1821248444
Registry record updated Sep 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
53251 Issued in CA
Practice address
816 E Lomita Ave
Glendale, CA 91205-1821
Phone
(818) 590-0822
NPI assigned
Sep 19, 2008
Last updated
Sep 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2008

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 53251 CA Primary

Addresses

Primary practice location

816 E Lomita Ave
Glendale, CA 91205-1821

Mailing address

816 E Lomita Ave
Glendale, CA 91205-1821
Phone (818) 590-0822

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
53251CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221782400000",
    "number": "1821248444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 E LOMITA AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051821",
            "telephone_number": "818-590-0822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 E LOMITA AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051821",
            "telephone_number": "818-590-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZARYAN",
        "first_name": "LEONIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-19",
        "last_updated": "2008-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.