Provider Demographics
NPI:1215225776
Name:NAGHMEH JAVAHERIAN DDS INC
Entity Type:Organization
Organization Name:NAGHMEH JAVAHERIAN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:NAGHMEH
Authorized Official - Middle Name:
Authorized Official - Last Name:JAVAHERIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-997-4528
Mailing Address - Street 1:16661 VENTURA BLVD.
Mailing Address - Street 2:STE: 407
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436
Mailing Address - Country:US
Mailing Address - Phone:818-997-4528
Mailing Address - Fax:818-788-2076
Practice Address - Street 1:16661 VENTURA BLVD.
Practice Address - Street 2:SUITE: 407
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436
Practice Address - Country:US
Practice Address - Phone:818-997-4528
Practice Address - Fax:818-788-2076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
423331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty