Provider Demographics
NPI:1336634575
Name:SONA KAZAZIAN D.D.S. INC.
Entity Type:Organization
Organization Name:SONA KAZAZIAN D.D.S. INC.
Other - Org Name:SONA KAZAZIAN D.D. S.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SONA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZAZIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-763-6869
Mailing Address - Street 1:12520 MAGNOLIA BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-2345
Mailing Address - Country:US
Mailing Address - Phone:818-763-6869
Mailing Address - Fax:818-763-0063
Practice Address - Street 1:12520 MAGNOLIA BLVD STE 203
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-2345
Practice Address - Country:US
Practice Address - Phone:818-763-6869
Practice Address - Fax:818-763-0063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB42339-01261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental