Healthcare Provider Details

I. General information

NPI: 1689519068
Provider Name (Legal Business Name): GHADOUSHI AND NOURIAN DENTAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14248 HAWTHORNE BLVD
HAWTHORNE CA
90250-7008
US

IV. Provider business mailing address

14248 HAWTHORNE BLVD
HAWTHORNE CA
90250-7008
US

V. Phone/Fax

Practice location:
  • Phone: 310-694-9546
  • Fax:
Mailing address:
  • Phone: 310-694-9546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. NATHAN A NOURIAN
Title or Position: OWNER
Credential: DDS
Phone: 310-482-8767