Active NPI
Neda Michelle Ghofranian, DMD
- Dentist
- Monrovia, CA
National Provider Identifier
1861983108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS103333
- Practice address
- 925 W Foothill Blvd Ste B
Monrovia, CA 91016-6603 - Phone
- (626) 873-1500
- NPI assigned
- May 22, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DDS103333 | CA | Primary |
| Dentist | 122300000X | D010010 | AZ |
Addresses
Primary practice location
925 W Foothill Blvd Ste B
Monrovia, CA 91016-6603
Mailing address
925 W Foothill Blvd Ste B
Monrovia, CA 91016-6603
Phone (626) 873-1500
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190812000570 | CA | Order and Referring Only - Dentist | 7719214915 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D010010 | AZ | MD | Dentist |
| DDS103333 | CA | MD | Dentist |
| 10333 | CA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Haig Gazarian Dental Corporation | Dentist | Past | Accepting new patients |
| Arizona Dental Professionals, P.C. | General Practice | Past | Accepting new patients |
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.
-
- Dentist
- Monrovia, CA
- NPI 1417415241
-
- General Practice Dentistry
- Buckeye, AZ
- NPI 1659875698
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559865600000",
"number": "1861983108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 W FOOTHILL BLVD STE B",
"city": "MONROVIA",
"state": "CA",
"postal_code": "910166603",
"telephone_number": "626-873-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 W FOOTHILL BLVD STE B",
"city": "MONROVIA",
"state": "CA",
"postal_code": "910166603",
"telephone_number": "626-873-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHOFRANIAN",
"first_name": "NEDA",
"middle_name": "MICHELLE",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-22",
"last_updated": "2019-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS103333",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D010010",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Monrovia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.