Healthcare Provider Details

I. General information

NPI: 1437530912
Provider Name (Legal Business Name): VAHAGN HAKOPYAN, DDS, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2015
Last Update Date: 06/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 N VERDUGO RD 302
GLENDALE CA
91208-1219
US

IV. Provider business mailing address

3600 N VERDUGO RD 302
GLENDALE CA
91208-1219
US

V. Phone/Fax

Practice location:
  • Phone: 818-839-7475
  • Fax: 818-839-7473
Mailing address:
  • Phone: 818-839-7475
  • Fax: 818-839-7473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number57791
License Number StateCA

VIII. Authorized Official

Name: DR. VAHAGN HAKOPYAN
Title or Position: PRESIDENT/OWNER
Credential: DDS
Phone: 818-839-7475