Provider Demographics
NPI:1114073350
Name:OHANIAN, CARMEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:
Last Name:OHANIAN
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 1:1110 N BRAND BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2567
Mailing Address - Country:US
Mailing Address - Phone:818-244-0215
Mailing Address - Fax:818-244-0267
Practice Address - Street 1:1101 N PACIFIC AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-3250
Practice Address - Country:US
Practice Address - Phone:818-244-0215
Practice Address - Fax:818-244-0267
Is Sole Proprietor?:No
Enumeration Date:2007-01-27
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA407011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice