NPIMap

Organization Active NPI

Rita Deragobian DDS Inc

  • Dentist
  • Montclair, CA
National Provider Identifier
1992127997
Registry record updated Jan 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
55480 Issued in CA
Legal business name
RITA DERAGOBIAN DDS INC
Practice address
9509 Central Ave Ste D
Montclair, CA 91763-2400
Phone
(909) 399-3330
NPI assigned
Jan 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2014

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

Authorized official

Name
Dr. Rita Deragobian, DDSNPI 1578742953
Title
Owner
Phone
(909) 399-3330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 55480 CA Primary

Addresses

Primary practice location

9509 Central Ave Ste D
Montclair, CA 91763-2400

Mailing address

9509 Central Ave Ste D
Montclair, CA 91763-2400
Phone (909) 399-3330

Other identifiers 1

IdentifierTypeStateIssuer
1578742953OtherCANPI

Other names 1

  • Glamour Dental Care Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1389225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389225600000",
    "number": "1992127997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9509 CENTRAL AVE STE D",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632400",
            "telephone_number": "909-399-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9509 CENTRAL AVE STE D",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632400",
            "telephone_number": "909-399-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITA DERAGOBIAN DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-09",
        "last_updated": "2014-01-09",
        "status": "A",
        "authorized_official_last_name": "DERAGOBIAN",
        "authorized_official_first_name": "RITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-399-3330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "55480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1578742953",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glamour Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montclair, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; 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.