Individual provider Active NPI

Njdeh Nick Ghazaryan, DDS

  • General Practice Dentistry
  • Pacoima, CA
National Provider Identifier
1851453427
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
53702 Issued in CA
Practice address
10445 Laurel Canyon Blvd
Pacoima, CA 91331-3605
Phone
(818) 970-5070
Fax
(818) 890-1474
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 53702 CA Primary

Addresses

Primary practice location

10445 Laurel Canyon Blvd
Pacoima, CA 91331-3605

Mailing address

812 E Glenoaks Blvd
Glendale, CA 91207-1715
Phone (818) 970-5070

Other practice location 1

8361 Laurel Canyon Blvd
Sun Valley, CA 91352-3809
Phone (818) 970-5070

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
53702CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Nezhde Ghazaryan Dental Corp. General Practice Current Accepting new patients
Ghazaryan Professional Dental Corp. General Practice Past Accepting new patients

Locations

10445 Laurel Canyon Blvd
Pacoima, CA 91331
Phone (818) 472-5609

Organizations & group practices 2

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1851453427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 E GLENOAKS BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912071715",
            "telephone_number": "818-970-5070",
            "fax_number": "818-890-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10445 LAUREL CANYON BLVD",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913313605",
            "telephone_number": "818-970-5070",
            "fax_number": "818-890-1474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8361 Laurel Canyon Blvd",
            "address_purpose": "LOCATION",
            "city": "Sun Valley",
            "state": "CA",
            "postal_code": "913523809",
            "country_code": "US",
            "telephone_number": "818-970-5070",
            "fax_number": "818-504-9259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHAZARYAN",
        "first_name": "NJDEH",
        "middle_name": "NICK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacoima, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.