Bagrat Abazyan

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18213 Issued in MD

Practice address

120 Patapsco Land Way
Brooklyn, MD 21225-2380

Phone

(443) 208-2177

NPI assigned

Sep 11, 2023

Last updated

Sep 11, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

State licenses

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.

• Sunshine Dental.Inc

  • General Practice Dentistry
  • Pikesville, MD
  • NPI 1528873445
  NPD Authorized official

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1902683477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PATAPSCO LAND WAY",
            "city": "BROOKLYN",
            "state": "MD",
            "postal_code": "212252380",
            "telephone_number": "443-208-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PATAPSCO LAND WAY",
            "city": "BROOKLYN",
            "state": "MD",
            "postal_code": "212252380",
            "telephone_number": "443-208-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABAZYAN",
        "first_name": "BAGRAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "18213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clement Adeboye Adebayo
• Eli Baladad Alegado, MD
• Ciera Dashawn Andrews, ADT
• Apple Health Systems
• Doris Akudazie Ben, NP-BC

• General Practice Dentistry in Brooklyn, MD
• Providers in Brooklyn, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.