MEDICARE: OHANIAN DENTAL CORPORATION

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	122300000X	Dentist	54481	CA

General Provider Information

NPI Number	:	1992043913
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHANIAN DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	10520 VICTORY BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-3917
Country	:	US
Telephone Number	:	818-980-6761
Fax Number	:	818-980-6763

Provider Business Practice Location Address
First Line	:	10520 VICTORY BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-3917
Country	:	US
Telephone Number	:	818-980-6761
Fax Number	:	818-980-6763

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. ARMINE OHANIAN
Credential	:	DMD
Telephone Number	:	818-442-1715

Provider Enumeration Date	:	01/25/2013
Last Update Date	:	01/25/2013

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Directions to “OHANIAN DENTAL CORPORATION ” Practice Location

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