Active NPI
Kristina Shagramanova
- Endodontics
- Glendale, CA
National Provider Identifier
1871533760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 55130
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| DS037131 | PA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New 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 | Past | 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.
-
- Endodontics
- Santa Clarita, CA
- NPI 1205627411
-
- Endodontics
- South Gate, CA
- NPI 1659938470
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.