Provider Demographics
NPI:1376524157
Name:SHNORHOKIAN, HOVHANNESS IVAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:HOVHANNESS
Middle Name:IVAN
Last Name:SHNORHOKIAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 NEILSON WAY,
Mailing Address - Street 2:UNIT 409
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-5364
Mailing Address - Country:US
Mailing Address - Phone:310-310-3605
Mailing Address - Fax:
Practice Address - Street 1:16542 VENTURA BLVD
Practice Address - Street 2:SUITE 515
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2005
Practice Address - Country:US
Practice Address - Phone:818-906-8008
Practice Address - Fax:818-906-8008
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA517661223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics