Healthcare Provider Details

I. General information

NPI: 1548967714
Provider Name (Legal Business Name): GEVORG GEORGE KARAYAN DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2023
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13741 VICTORY BLVD
VAN NUYS CA
91401-2348
US

IV. Provider business mailing address

13741 VICTORY BLVD
VAN NUYS CA
91401-2348
US

V. Phone/Fax

Practice location:
  • Phone: 818-753-8883
  • Fax:
Mailing address:
  • Phone: 818-753-8883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. GEVORG GEORGE KARAYAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: DDS
Phone: 818-388-7377