Provider Demographics
NPI:1083818637
Name:HOVSEP NARGIZYAN, DDS, INC.
Entity Type:Organization
Organization Name:HOVSEP NARGIZYAN, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOVSEP
Authorized Official - Middle Name:
Authorized Official - Last Name:NARGIZYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-342-1448
Mailing Address - Street 1:81637 HIGHWAY 111
Mailing Address - Street 2:SUITE #1
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201
Mailing Address - Country:US
Mailing Address - Phone:760-342-1448
Mailing Address - Fax:760-342-2778
Practice Address - Street 1:81637 HIGHWAY 111
Practice Address - Street 2:SUITE #1
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201
Practice Address - Country:US
Practice Address - Phone:760-342-1448
Practice Address - Fax:760-342-2778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA511121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty