Individual provider Active NPI

Kristina Shagramanova

  • Endodontics
  • Glendale, CA
National Provider Identifier
1871533760
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
55130 Issued in CA
Practice address
410 W Colorado St
Glendale, CA 91204-1504
Phone
(818) 956-9907
Fax
(818) 956-9914
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS037131 PA
Electroneurodiagnostic Specialist/Technologist 246ZE0600X
Endodontics 1223E0200X 55130 CA Primary

Addresses

Primary practice location

410 W Colorado St
Glendale, CA 91204-1504

Mailing address

7924 Woodman Ave
Suite27
Van Nuys, CA 91402-6246
Phone (818) 636-9208

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
DS037131PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
La Smiles Endodontics Endodontics Current Accepting new patients
Natalya Shagramanova D.D.S. Inc. General Practice Past Accepting new patients
K. Shagramanova Dental Corp. Endodontics PastSince Apr 20, 2021 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1871533760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7924 WOODMAN AVE",
            "address_2": "SUITE27",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914026246",
            "telephone_number": "818-636-9208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W COLORADO ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041504",
            "telephone_number": "818-956-9907",
            "fax_number": "818-956-9914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAGRAMANOVA",
        "first_name": "KRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS037131",
            "primary": false
        },
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "55130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; 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.