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NPI Code Detail

MEDICARE: OVSEP LUSINYAN D.D.S.

MEDICARE: OVSEP LUSINYAN 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
1122300000XDentistB36314CA

General Provider Information

NPI Number : 1790912210
Entity Type Code : Organization
Provider Name (Legal Business Name) : OVSEP LUSINYAN D.D.S.
Provider Business Mailing Address
First Line : 501 W GLENOAKS BLVD
Second Line : #12
City : GLENDALE
State : CA
Zip : 91202-2896
Country : US
Telephone Number : 818-500-7978
Fax Number : 818-500-7827
Provider Business Practice Location Address
First Line : 501 W GLENOAKS BLVD
Second Line : #12
City : GLENDALE
State : CA
Zip : 91202-2896
Country : US
Telephone Number : 818-500-7978
Fax Number : 818-500-7827
Authorized Official
Title or Position : DENTIST
Name : DR. OVSEP LUSINYAN
Credential : D.D.S.
Telephone Number : 818-500-7978
Provider Enumeration Date : 06/11/2009
Last Update Date : 06/11/2009

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Directions to “OVSEP LUSINYAN D.D.S. ” Practice Location

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