Provider Demographics
NPI:1093866311
Name:HATUTIAN, GARY ZAVEN (DDS)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:ZAVEN
Last Name:HATUTIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10480 W 177TH TER
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-9563
Mailing Address - Country:US
Mailing Address - Phone:913-685-8148
Mailing Address - Fax:
Practice Address - Street 1:8605 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1835
Practice Address - Country:US
Practice Address - Phone:913-451-1606
Practice Address - Fax:913-451-1483
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6707122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist