Provider Demographics
NPI:1043678782
Name:ANAIT ALABYAN D.D.S., INC.
Entity Type:Organization
Organization Name:ANAIT ALABYAN D.D.S., INC.
Other - Org Name:OXNARD PREMIUM DENTAL, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANAIT
Authorized Official - Middle Name:
Authorized Official - Last Name:ALABYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-378-8208
Mailing Address - Street 1:451 W GONZALES RD
Mailing Address - Street 2:SUITE #110
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-9004
Mailing Address - Country:US
Mailing Address - Phone:805-485-2334
Mailing Address - Fax:805-485-2354
Practice Address - Street 1:451 W GONZALES RD
Practice Address - Street 2:SUITE #110
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-9004
Practice Address - Country:US
Practice Address - Phone:805-485-2334
Practice Address - Fax:805-485-2354
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANAIT ALABYAN DDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA527071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty