Provider Demographics
NPI:1285357624
Name:MIRZOYAN KALACH, TALIN (DDS)
Entity type:Individual
Prefix:DR
First Name:TALIN
Middle Name:
Last Name:MIRZOYAN KALACH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 TEXAS ST UNIT 1908
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-3705
Mailing Address - Country:US
Mailing Address - Phone:818-397-9223
Mailing Address - Fax:
Practice Address - Street 1:24437 KATY FWY STE 500
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1469
Practice Address - Country:US
Practice Address - Phone:281-394-9340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-21
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390721223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics