Active NPI
Garik Oganesian, DDS
- General Practice Dentistry
- San Mateo, CA
National Provider Identifier
1962908319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 104121
- Practice address
- 800 S B St
San Mateo, CA 94401-4271 - Phone
- (559) 916-9301
- NPI assigned
- Apr 4, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | 104121 | CA | Primary |
Addresses
Primary practice location
800 S B St
San Mateo, CA 94401-4271
Mailing address
222 8TH Ave Apt 310
San Mateo, CA 94401-4270
Phone (559) 916-9301
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 |
|---|---|---|---|
| 104121 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604966400000",
"number": "1962908319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 8TH AVE APT 310",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944014270",
"telephone_number": "559-916-9301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 S B ST",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944014271",
"telephone_number": "559-916-9301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OGANESIAN",
"first_name": "GARIK",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-04",
"last_updated": "2020-11-10",
"certification_date": "2020-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "104121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.