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Organization
YEGHISHEH MIRZOYAN D.D.S., INC.
Active
Organization
YEGHISHEH MIRZOYAN D.D.S., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YEGHISHEH MIRZOYAN D.D.S. (DENTIST)
(818) 419-0047
Entity
Organization
Contact information
Practice address
14435 SHERMAN WAY STE 110, VAN NUYS, CA 91405-6229
(818) 927-3113
(818) 547-5510
Mailing address
6440 GREENBUSH AVE, VAN NUYS, CA 91401-1839
(818) 403-7655
(818) 547-5510
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
CA
1223G0001X
General Practice Dentistry
Primary
63761
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
44534
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184771818
—
CA
05
—
1497156038
—
CA
Enumeration date
11/30/2015
Last updated
07/21/2022
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