GLENDALE SURGICAL ASSOCIATES (NPI# 1205090610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205090610 |
| Entity Type | Organization |
| Organization Name | GLENDALE SURGICAL ASSOCIATES |
| Other Organization Name | PACIFIC COAST OMS |
| Practice Address |
1146 N Brand Blvd Glendale CA 91202-2504 |
| Mailing Address |
221 E Glenoaks Blvd Suite #140 Glendale CA 91207 |
| Practice Telephone | 8182414217 |
| Mailing Telephone | 8182414217 |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2018-04-20 |
| Authorized Official Name | DR. NAM CHO (PARTNER/OWNER) |
| Authorized Official Telephone | 2063560449 |
| Authorized Official Credential | M.D., D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
OMS71 | CA | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
OMS94 | CA | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
37945 | CA | Dental Providers |
| Other Name | Type Code |
|---|---|
| Pacific Coast OMS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144708850 | Glendale Surgical Associates | Oral & Maxillofacial Surgery | 550 W Duarte Rd, Suite 7, Arcadia, CA 91007 | 2018-08-03 |
| Street Address |
1146 N BRAND BLVD |
| City | GLENDALE |
| State | CA |
| Zip Code | 91202-2504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689725780 | Joseph F Goodsell | Dentist | 1146 N Brand Blvd, Glendale, CA 91202-2504 | 2007-01-15 |
| 1437537107 | Brand Surgery Center, LLC | Clinic/Center | 1146 N Brand Blvd, Glendale, CA 91202-2504 | 2015-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528538857 | Forever Active Cbas | Clinic/Center | 1111 W Glenoaks Blvd, Glendale, CA 91202 | 2018-11-29 |
| 1144724436 | Kristine Bustos | Nurse Practitioner | 1200 N Pacific Ave Ste 104, Glendale, CA 91202 | 2018-03-21 |
| 1295159614 | Kevin Lew | Dentist | 1122 N. Brand Blvd. Suite 102, Glendale, CA 91202 | 2014-02-05 |
| 1568709350 | Helen Chalakians | Counselor | 525 Glenwood Rd, Glendale, CA 91202 | 2013-01-14 |
| 1316216161 | Teresa Eligio | Nurse Practitioner | 857 Grant Ave, Glendale, CA 91202 | 2011-12-23 |
| 1033486139 | Advance Hospice Care, Inc. | Home Health | 1209 N. Central Ave Suite 204, Glendale, CA 91202 | 2011-11-18 |
| 1659518785 | Sarine Davityan | Marriage & Family Therapist | 1010 N Central Ave # 310, Glendale, CA 91202 | 2009-01-12 |
| 1760635619 | Tatiana Mikaelian Dds Inc | Dentist | 1209 N. Central Ave, #203, Glendale, CA 91202 | 2008-10-23 |
| 1669624219 | Marine Demirjian | Allergy & Immunology | 1131 N Pacific Ave, Glendale, CA 91202 | 2008-10-15 |
| 1902055783 | Lousine Vahagn Kirakosian | Dentist | 125 E. Glenoaks Blvd., Suite 103, Glendale, CA 91202 | 2008-09-16 |
| Find all providers in zip 91202 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255945366 | Phoenix Wisdom Teeth, LLC | Dentist | 17037 N 43rd Ave # A4a, Glendale, AZ 85308-4026 | 2020-09-04 |
| 1750738555 | Omar Kholaki | Dentist | 3863 Sky View Ln, Glendale, CA 91214-1006 | 2016-05-21 |
| 1891182507 | Armand Keuroghlian | Dentist | 1044 Trafalger Dr, Glendale, CA 91207-1140 | 2015-04-20 |
| 1932518107 | Ara Mirzaians | Dentist | 500 N Central Ave Ste 710, Glendale, CA 91203-3386 | 2014-08-12 |
| 1134567381 | Eric Edward Saiz | Dentist | 6677 W Thunderbird Rd Ste H120, Glendale, AZ 85306-3726 | 2013-06-10 |
| 1376841015 | Christopher P. Mcaboy Dds, LLC | Dentist | 377 W River Woods Pkwy # 120, Glendale, WI 53212-1088 | 2011-03-04 |
| 1508196437 | Peter S Nelson | Dentist | 5750 W Thunderbird Rd Ste H850, Glendale, AZ 85306-4694 | 2009-12-25 |
| 1396868774 | Armond Kotikian | Dentist | 242 N. Glendale Ave, Glendale, CA 91206 | 2007-04-09 |
| 1316081623 | Hamlet Charmahali Garabedian | Dentist | 242 N Glendale Ave, Glendale, CA 91206-4454 | 2007-02-19 |
| 1689725780 | Joseph F Goodsell | Dentist | 1146 N Brand Blvd, Glendale, CA 91202-2504 | 2007-01-15 |
| Find all providers in GLENDALE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.