Healthcare Provider Details

I. General information

NPI: 1083549976
Provider Name (Legal Business Name): ALAN LAVIANDDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11274 FIRESTONE BLVD
NORWALK CA
90650-2288
US

IV. Provider business mailing address

811 HUNTLEY DR
WEST HOLLYWOOD CA
90069-5001
US

V. Phone/Fax

Practice location:
  • Phone: 310-500-5238
  • Fax:
Mailing address:
  • Phone: 310-500-5238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ALAN LAVIAN
Title or Position: CEO/PRESIDENT
Credential: DDS
Phone: 310-500-5238