Provider Demographics
NPI:1083498372
Name:JOHN OGANESYAN DDS., INC
Entity Type:Organization
Organization Name:JOHN OGANESYAN DDS., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:OGANESYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-200-3491
Mailing Address - Street 1:1127 WILSHIRE BLVD STE 903
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-3910
Mailing Address - Country:US
Mailing Address - Phone:213-481-1155
Mailing Address - Fax:213-481-1156
Practice Address - Street 1:1127 WILSHIRE BLVD STE 903
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-3910
Practice Address - Country:US
Practice Address - Phone:213-481-1155
Practice Address - Fax:213-481-1156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty