Provider Demographics
NPI:1104967553
Name:BEKEREDJIAN, HOVANES JOHN
Entity type:Individual
Prefix:DR
First Name:HOVANES
Middle Name:JOHN
Last Name:BEKEREDJIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3171 LOS FELIZ BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-1537
Mailing Address - Country:US
Mailing Address - Phone:323-663-3662
Mailing Address - Fax:323-663-2268
Practice Address - Street 1:3171 LOS FELIZ BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-1537
Practice Address - Country:US
Practice Address - Phone:323-663-3662
Practice Address - Fax:323-663-2268
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38036122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist