| NPI | 1104987445 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-12-12 |
| Last Updated | 2012-09-04 |
| Authorized Official | Benita Evazyan Dentist Phone: 8185060100 |
| Mailing Address | 12143 Magnolia Blvd Valley Village, CA 91607-2609 United States Phone: (818) 506-0100 | Fax: (818) 506-0700 📍 View Map |
| Primary Practice Address | 12143 Magnolia Blvd Valley Village, CA 91607-2609 United States Phone: (818) 506-0100 | Fax: (818) 506-0700 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 122300000X – Dentist | CA | 47472 |
| Yes | 122300000X – Dentist | CA | 43949 |
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About NPI 1104987445
Evazyan Dental Corp is an organization registered in the CMS NPPES NPI Registry with NPI number 1104987445. The primary specialty listed is Dentist. The organization is located in Valley Village, CA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-12-12. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1104987445?
NPI 1104987445 belongs to Evazyan Dental Corp, a Dentist in Valley Village, CA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1104987445 active?
The current status of NPI 1104987445 in the NPPES registry is Active. The record was last updated on 2012-09-04.
What specialty is NPI 1104987445?
NPI 1104987445 is classified under the taxonomy Dentist. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1104987445?
You can verify NPI 1104987445 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1104987445?
The primary practice address on file for NPI 1104987445 is 12143 Magnolia Blvd, Valley Village, CA 91607-2609. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1104987445 issued?
NPI 1104987445 was first issued (enumerated) on 2006-12-12. The NPPES record was last updated on 2012-09-04.
Practice Location Map
Evazyan Dental Corp is located at 12143 Magnolia Blvd, Valley Village, CA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Evazyan Dental Corp. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1104987445. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Dentist | 47472 | CA |
| Dentist | 43949 | CA |