Iren Mkrtychyan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

106884 Issued in CA

Practice address

3268 Greyling Dr
San Diego, CA 92123-2230

Phone

(858) 617-0620

NPI assigned

Oct 5, 2021

Last updated

Oct 5, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fedor Dental Corporation

  dba Serra Mesa Modern Dentistry Dental Group

  • Dentist
  • San Diego, CA
  • NPI 1871071795
  NPD (past)

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1902578206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7297 SITIO LIRIO",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920099529",
            "telephone_number": "760-828-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3268 GREYLING DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232230",
            "telephone_number": "858-617-0620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3945 1st Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921033015",
            "country_code": "US",
            "telephone_number": "619-294-4015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MKRTYCHYAN",
        "first_name": "IREN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "106884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyoka Mizuno
• Mizuta & Associates Physical Therapy, Inc. (Mizuta & Associates Physical Therapy)
• Ericka Craft Mizuta, DPT
• Anna Mercedes Mizzell, MD
• MK Naturopathic and Acupuncture Inc (MK Integrative Wellness)
• Eric Mlodzinski
• MML US Inc.
• Mnanna World,Inc (Comfort Shoe Center)
• Christina Louise Mnatzaganian, PHARM.D.
• Alice Mo, M.D.

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.