| Nigoghosian Dental Group Inc | |
|
2488 Foothill Blvd Ste C La Verne CA 91750-3062 | |
| (909) 596-1155 | |
| Not Available |
| Full Name | Nigoghosian Dental Group Inc |
|---|---|
| Speciality | Dentist |
| Location | 2488 Foothill Blvd Ste C, La Verne, California |
| Authorized Official Name and Position | Johnny V Nigoghosian (OWNER) |
| Authorized Official Contact | 9095961155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nigoghosian Dental Group Inc 2488 Foothill Blvd Ste C La Verne CA 91750-3062 Ph: (909) 596-1155 | Nigoghosian Dental Group Inc 2488 Foothill Blvd Ste C La Verne CA 91750-3062 Ph: (909) 596-1155 |
| NPI Number | 1326501891 |
|---|---|
| Provider Enumeration Date | 04/10/2019 |
| Last Update Date | 04/16/2020 |
| Medicare PECOS PAC ID | 6305267659 |
|---|---|
| Medicare Enrollment ID | O20200522001013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326501891 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Johnny Nigoghosian |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1821402538 PECOS PAC ID: 3577994854 Enrollment ID: I20200522001078 |
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