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General NPI Number Information
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NPI Number | 1578130761
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Entity Type | Individual
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Provider Name | MICHAEL KOHAN-GHADOSH DDS
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Gender | Male
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Dates
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Enumeration Date | 06/07/2021
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 16111 PLUMMER ST
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City | NORTH HILLS
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State | CA
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Zip | 91343-2036
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Country | US
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Telephone | 310-825-2337
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Fax |
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Provider Business Mailing Address
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Address Line | 6660 DREXEL AVE
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City | LOS ANGELES
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State | CA
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Zip | 90048-4209
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Country | US
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Telephone | 310-430-2068
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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 | DDS109204
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License Number State | CA
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