Provider Demographics
NPI:1356499693
Name:KOSHKERIAN, HOVSEP (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOVSEP
Middle Name:
Last Name:KOSHKERIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13060 GLENOAKS BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-3963
Mailing Address - Country:US
Mailing Address - Phone:818-899-1800
Mailing Address - Fax:818-833-6900
Practice Address - Street 1:13060 GLENOAKS BLVD STE 105
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-3963
Practice Address - Country:US
Practice Address - Phone:818-899-1800
Practice Address - Fax:818-833-6900
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53719122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5371901OtherMEDICAL PROVIDER