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General NPI Number Information
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NPI Number | 1427426626
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Entity Type | Organization
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Legal Business Name | HOVSEP KOSHKERIAN DDS, INC.
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Dates
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Enumeration Date | 09/04/2015
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Last Update Date | 12/23/2015
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Provider Practice Location Address
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Address Line | 13060 GLENOAKS BLVD STE 105
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City | SYLMAR
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State | CA
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Zip | 91342-3963
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Country | US
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Telephone | 818-899-1800
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Fax | 818-833-6900
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Provider Business Mailing Address
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Address Line | 13060 GLENOAKS BLVD STE 105
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City | SYLMAR
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State | CA
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Zip | 91342-3963
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Country | US
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Telephone | 818-899-1800
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Fax | 818-833-6900
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Authorized Official
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Title or Position | DENTIST
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Name | HOVSEP KOSHKERIAN
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Credential | DDS
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Telephone | 818-641-9955
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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 | 53719
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License Number State | CA
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