Individual provider Active NPI

Neda Michelle Ghofranian, DMD

  • Dentist
  • Monrovia, CA
National Provider Identifier
1861983108
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS103333 Issued in CA
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

Updated by the provider on Jun 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190812000570 CA Order and Referring Only - DentistPractitioner - Dentist 7719214915

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D010010AZMDDentist
DDS103333CAMDDentist
10333CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.