MEDICARE: ARMEN MINASYAN DDS

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	56103	CA

General Provider Information

NPI Number	:	1720270937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARMEN MINASYAN DDS

Provider Business Mailing Address
First Line	:	10903 MAGNOLIA BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-3904
Country	:	US
Telephone Number	:	818-345-0007
Fax Number	:	818-345-1360

Provider Business Practice Location Address
First Line	:	10903 MAGNOLIA BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-3904
Country	:	US
Telephone Number	:	818-345-0007
Fax Number	:	818-345-1360

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

Provider Enumeration Date	:	08/11/2007
Last Update Date	:	07/21/2022

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