| Minasyan Dental, Inc | |
|
5953 Laurel Canyon Blvd Unit B Valley Village CA 91607-5224 | |
| (818) 210-1010 | |
| Not Available |
| Full Name | Minasyan Dental, Inc |
|---|---|
| Speciality | Dentist |
| Location | 5953 Laurel Canyon Blvd, Valley Village, California |
| Authorized Official Name and Position | Kharen Minasyan (PRESIDENT) |
| Authorized Official Contact | 8182101010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Minasyan Dental, Inc 5953 Laurel Canyon Blvd Unit B Valley Village CA 91607-5224 Ph: (818) 210-1010 | Minasyan Dental, Inc 5953 Laurel Canyon Blvd Unit B Valley Village CA 91607-5224 Ph: (818) 210-1010 |
| NPI Number | 1831541846 |
|---|---|
| Provider Enumeration Date | 07/01/2016 |
| Last Update Date | 10/05/2017 |
| Medicare PECOS PAC ID | 1052676244 |
|---|---|
| Medicare Enrollment ID | O20180516002843 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831541846 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 53088 (California) | Primary |
| Provider Name | Kharen Minasyan |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1447346762 PECOS PAC ID: 3779890439 Enrollment ID: I20180516002876 |
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