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General NPI Number Information
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NPI Number | 1376524157
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Entity Type | Individual
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Provider Name | HOVHANNESS IVAN SHNORHOKIAN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 04/21/2009
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Provider Practice Location Address
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Address Line | 16542 VENTURA BLVD SUITE 515
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City | ENCINO
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State | CA
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Zip | 91436-2005
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Country | US
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Telephone | 818-906-8008
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Fax | 818-906-8008
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Provider Business Mailing Address
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Address Line | 2950 NEILSON WAY, UNIT 409
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City | SANTA MONICA
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State | CA
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Zip | 90405-5364
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Country | US
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Telephone | 310-310-3605
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 51766
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License Number State | CA
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