Provider Demographics
NPI:1285670133
Name:OGANYAN, ALINA (DDS)
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:OGANYAN
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 1:1727 N VERMONT AVE
Mailing Address - Street 2:SUITE #109
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-4343
Mailing Address - Country:US
Mailing Address - Phone:323-644-3366
Mailing Address - Fax:323-644-0838
Practice Address - Street 1:1727 N VERMONT AVE
Practice Address - Street 2:SUITE #109
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-4343
Practice Address - Country:US
Practice Address - Phone:323-644-3366
Practice Address - Fax:323-644-0838
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA463131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice