Provider Demographics
NPI:1528873445
Name:SUNSHINE DENTAL.INC
Entity type:Organization
Organization Name:SUNSHINE DENTAL.INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:BAGRAT
Authorized Official - Middle Name:
Authorized Official - Last Name:ABAZYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:443-208-2177
Mailing Address - Street 1:120 PATAPSCO LAND WAY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:MD
Mailing Address - Zip Code:21225-2380
Mailing Address - Country:US
Mailing Address - Phone:443-208-2177
Mailing Address - Fax:
Practice Address - Street 1:1777 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-1380
Practice Address - Country:US
Practice Address - Phone:443-208-2177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty