Provider Demographics
NPI:1124033667
Name:HOVSEPYAN, GOHAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:GOHAR
Middle Name:
Last Name:HOVSEPYAN
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 1:15333 SHERMAN WAY
Mailing Address - Street 2:SUITE M
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-4206
Mailing Address - Country:US
Mailing Address - Phone:818-909-0200
Mailing Address - Fax:818-909-9386
Practice Address - Street 1:15333 SHERMAN WAY
Practice Address - Street 2:SUITE M
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-4206
Practice Address - Country:US
Practice Address - Phone:818-909-0200
Practice Address - Fax:818-909-9386
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA495431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice