Individual provider Active NPI

Krikor Simonian, D.D.S.

  • Periodontics
  • Pasadena, CA
National Provider Identifier
1942328604
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
38226 Issued in CA
Practice address
1156 E Green St
Suite 102
Pasadena, CA 91106-2515
Phone
(626) 578-1853
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 38226 CA Primary

Addresses

Primary practice location

1156 E Green St
Suite 102
Pasadena, CA 91106-2515

Mailing address

1156 E Green St
Suite 102
Pasadena, CA 91106-2515
Phone (626) 578-1853

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
38226CAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942328604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 E GREEN ST",
            "address_2": "SUITE 102",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062515",
            "telephone_number": "626-578-1853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 E GREEN ST",
            "address_2": "SUITE 102",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062515",
            "telephone_number": "626-578-1853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONIAN",
        "first_name": "KRIKOR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "38226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.