Individual provider Active NPI

Johnny Nigoghosian, D.D.S.

  • Dentist
  • Monrovia, CA
National Provider Identifier
1821402538
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63485 Issued in CA
Practice address
251 Grand Ave
Monrovia, CA 91016-2359
Phone
(626) 429-9723
NPI assigned
Jun 20, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 63485 CA Primary

Addresses

Primary practice location

251 Grand Ave
Monrovia, CA 91016-2359

Mailing address

251 Grand Ave
Monrovia, CA 91016-2359
Phone (626) 429-9723

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
I20200522001078 CA Practitioner - Oral Surgery 3577994854

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63485CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nigoghosian & Nigoghosian DDS Inc CurrentSince Mar 1, 2020 Accepting new patients

Locations

1049 W Foothill Blvd
Upland, CA 91786
Phone (909) 660-6080

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": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403222400000",
    "number": "1821402538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 GRAND AVE",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910162359",
            "telephone_number": "626-429-9723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 GRAND AVE",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910162359",
            "telephone_number": "626-429-9723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIGOGHOSIAN",
        "first_name": "JOHNNY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-20",
        "last_updated": "2014-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monrovia, CA

Sources for this page

Verify at the official NPI Registry.