Provider Demographics
NPI:1093246100
Name:GALSTIAN, SONA (DMD)
Entity Type:Individual
Prefix:
First Name:SONA
Middle Name:
Last Name:GALSTIAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38209 47TH ST E STE E
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93552-3113
Mailing Address - Country:US
Mailing Address - Phone:661-236-0046
Mailing Address - Fax:
Practice Address - Street 1:38209 47TH ST E STE E
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93552
Practice Address - Country:US
Practice Address - Phone:661-236-0046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
CA103037122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program