Active NPI
Geoffrey Noel Shanklin, D.D.S.
- General Practice Dentistry
- Glendale, CA
National Provider Identifier
1982820064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22667
- Practice address
- 1122 N Brand Blvd
#202
Glendale, CA 91202-2547 - Phone
- (818) 242-1372
- NPI assigned
- Apr 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22667 | CA | Primary |
Addresses
Primary practice location
1122 N Brand Blvd
#202
Glendale, CA 91202-2547
Mailing address
1122 N Brand Blvd
#202
Glendale, CA 91202-2547
Phone (818) 242-1372
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 |
|---|---|---|---|
| 22667 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anahid Acopian DDS, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Glendale, CA
- NPI 1245705888
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223510400000",
"number": "1982820064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1122 N BRAND BLVD",
"address_2": "#202",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912022547",
"telephone_number": "818-242-1372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1122 N BRAND BLVD",
"address_2": "#202",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912022547",
"telephone_number": "818-242-1372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANKLIN",
"first_name": "GEOFFREY",
"middle_name": "NOEL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-18",
"last_updated": "2008-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "22667",
"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 Oct 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.