Individual provider Active NPI

Raffie Garabedian, DMD, MS

  • Periodontics
  • Glendale, CA
National Provider Identifier
1841710316
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
101453 Issued in CA
Practice address
1000 N Central Ave Ste 130
Glendale, CA 91202-3686
Phone
(818) 588-0440
NPI assigned
Jun 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 101453 CA
Periodontics 1223P0300X 101453 CA Primary

Addresses

Primary practice location

1000 N Central Ave Ste 130
Glendale, CA 91202-3686

Mailing address

1055 Ruberta Ave Apt 1
Glendale, CA 91201-2195
Phone (818) 588-0440

Other practice location 1

925 W 34th St
Los Angeles, CA 90089-0058
Phone (818) 588-0440

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
I20200604000443 CA Practitioner - Oral SurgeryPractitioner - Dentist 3274954904

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Garabedian Dental Group Inc CurrentSince Jul 4, 2021 Accepting new patients
Garabedian DDS, Inc. Current Accepting new patients
Vinod G. Rana, DDS., Inc General Practice PastSince Mar 3, 2020 Accepting new patients

Locations

23595 Moulton Pkwy
Ste I
Laguna Hills, CA 92653
Phone (949) 317-3197

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1841710316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 RUBERTA AVE APT 1",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912012195",
            "telephone_number": "818-588-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N CENTRAL AVE STE 130",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912023686",
            "telephone_number": "818-588-0440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 W 34th St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900890058",
            "country_code": "US",
            "telephone_number": "818-588-0440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARABEDIAN",
        "first_name": "RAFFIE",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-26",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "101453",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "101453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.