Provider Demographics
NPI:1316540776
Name:OSSAIAN DENTAL CORPORATION
Entity Type:Organization
Organization Name:OSSAIAN DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSSAIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-849-5077
Mailing Address - Street 1:14061 VANOWEN ST
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-4144
Mailing Address - Country:US
Mailing Address - Phone:818-849-5077
Mailing Address - Fax:818-936-0669
Practice Address - Street 1:14061 VANOWEN ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4144
Practice Address - Country:US
Practice Address - Phone:818-849-5077
Practice Address - Fax:818-936-0669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental