MEDICARE: ALINA OGANYAN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	46313	CA

General Provider Information

NPI Number	:	1285670133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALINA OGANYAN D.D.S.

Provider Business Mailing Address
First Line	:	1727 N VERMONT AVE
Second Line	:	SUITE #109
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-4343
Country	:	US
Telephone Number	:	323-644-3366
Fax Number	:	323-644-0838

Provider Business Practice Location Address
First Line	:	1727 N VERMONT AVE
Second Line	:	SUITE #109
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-4343
Country	:	US
Telephone Number	:	323-644-3366
Fax Number	:	323-644-0838

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	12/29/2009

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