| Hovsep Nargizyan Professional Dental Corp | |
|
5216 Laurel Canyon Blvd Valley Village CA 91607-2710 | |
| (818) 786-8494 | |
| (818) 786-8492 |
| Full Name | Hovsep Nargizyan Professional Dental Corp |
|---|---|
| Speciality | Dentist |
| Location | 5216 Laurel Canyon Blvd, Valley Village, California |
| Authorized Official Name and Position | Hovsep Nargizyan (OWNER) |
| Authorized Official Contact | 8187868494 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hovsep Nargizyan Professional Dental Corp 5216 Laurel Canyon Blvd Valley Village CA 91607-2710 Ph: (818) 786-8494 | Hovsep Nargizyan Professional Dental Corp 5216 Laurel Canyon Blvd Valley Village CA 91607-2710 Ph: (818) 786-8494 |
| NPI Number | 1104269976 |
|---|---|
| Provider Enumeration Date | 04/11/2013 |
| Last Update Date | 02/22/2023 |
| Medicare PECOS PAC ID | 9931445442 |
|---|---|
| Medicare Enrollment ID | O20190103002725 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104269976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 1223G0001X | Dentist - General Practice | 51112 (California) | Primary |
| Provider Name | Hovsep Nargizyan |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1982799276 PECOS PAC ID: 2769771658 Enrollment ID: I20190103002920 |
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