| Oganesyan Dental Corporation | |
|
313 E Broadway # 1625 Glendale CA 91205-1010 | |
| (818) 232-7227 | |
| Not Available |
| Full Name | Oganesyan Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 313 E Broadway # 1625, Glendale, California |
| Authorized Official Name and Position | Tevan Oganesyan (OWNER) |
| Authorized Official Contact | 9496464300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oganesyan Dental Corporation 313 E Broadway # 1625 Glendale CA 91205-1010 Ph: (818) 232-7227 | Oganesyan Dental Corporation 313 E Broadway # 1625 Glendale CA 91205-1010 Ph: (818) 232-7227 |
| NPI Number | 1407204522 |
|---|---|
| Provider Enumeration Date | 05/31/2016 |
| Last Update Date | 06/29/2021 |
| Medicare PECOS PAC ID | 7618254806 |
|---|---|
| Medicare Enrollment ID | O20170703000448 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407204522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| Provider Name | Tevan Oganesyan |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1457669046 PECOS PAC ID: 7113238452 Enrollment ID: I20150616000470 |
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