Provider Demographics
NPI:1720815749
Name:GOHAR HOVSEPYAN D.D.S., INC.
Entity type:Organization
Organization Name:GOHAR HOVSEPYAN D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GOHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HOVSEPYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-909-0200
Mailing Address - Street 1:15333 SHERMAN WAY STE M
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-4204
Mailing Address - Country:US
Mailing Address - Phone:818-909-0200
Mailing Address - Fax:
Practice Address - Street 1:15333 SHERMAN WAY STE M
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-4204
Practice Address - Country:US
Practice Address - Phone:818-909-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-14
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty