Provider Demographics
NPI:1053056283
Name:HOVSEPIAN, DEENA (DDS)
Entity Type:Individual
Prefix:
First Name:DEENA
Middle Name:
Last Name:HOVSEPIAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12740 N WATT LN UNIT E
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-4889
Mailing Address - Country:US
Mailing Address - Phone:818-445-5272
Mailing Address - Fax:
Practice Address - Street 1:71949 HIGHWAY 111 STE 100B
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4826
Practice Address - Country:US
Practice Address - Phone:760-565-6055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1077591223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program