Provider Demographics
NPI:1275750465
Name:TAHMASSIAN, HERMINEH (DMD)
Entity Type:Individual
Prefix:DR
First Name:HERMINEH
Middle Name:
Last Name:TAHMASSIAN
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 1:5040 EAGLE ROCK BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-1924
Mailing Address - Country:US
Mailing Address - Phone:323-254-5547
Mailing Address - Fax:323-255-6085
Practice Address - Street 1:5040 EAGLE ROCK BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-1924
Practice Address - Country:US
Practice Address - Phone:323-254-5547
Practice Address - Fax:323-255-6085
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA480341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice