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General NPI Number Information
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NPI Number | 1346339173
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Entity Type | Individual
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Provider Name | TOM V SHANAKIAN DDS
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 12/19/2017
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Provider Practice Location Address
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Address Line | 5151 HAZELTINE AVE
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-1116
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Country | US
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Telephone | 818-788-2023
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Fax | 818-788-1830
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Provider Business Mailing Address
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Address Line | 9249 CANTER LN
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City | SUN VALLEY
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State | CA
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Zip | 91352-3733
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Country | US
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Telephone | 818-314-4246
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 52113
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License Number State | CA
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