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NPI Code Detail

MEDICARE: NICK GHAZARYAN DENTAL CORP

MEDICARE: NICK GHAZARYAN DENTAL CORP
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
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1518433986
Entity Type Code : Organization
Provider Name (Legal Business Name) : NICK GHAZARYAN DENTAL CORP
Provider Business Mailing Address
First Line : 16850 SAN FERNANDO MISSION BLVD
Second Line :
City : GRANADA HILLS
State : CA
Zip : 91344-4247
Country : US
Telephone Number : 818-970-5070
Fax Number :
Provider Business Practice Location Address
First Line : 16850 SAN FERNANDO MISSION BLVD
Second Line :
City : GRANADA HILLS
State : CA
Zip : 91344-4247
Country : US
Telephone Number : 818-970-5070
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. NJDEH GHAZARYAN
Credential : DDS
Telephone Number : 818-970-5070
Provider Enumeration Date : 10/23/2018
Last Update Date : 10/23/2018

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Directions to “NICK GHAZARYAN DENTAL CORP ” Practice Location

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