Provider Demographics
NPI:1417274788
Name:TSOLAIR HOVSEPIAN DDS INC
Entity Type:Organization
Organization Name:TSOLAIR HOVSEPIAN DDS INC
Other - Org Name:SMILES NORTHRIDGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TSOLAIR
Authorized Official - Middle Name:
Authorized Official - Last Name:HOVSEPIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-709-6464
Mailing Address - Street 1:9535 RESEDA BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-2310
Mailing Address - Country:US
Mailing Address - Phone:818-709-6464
Mailing Address - Fax:818-709-6419
Practice Address - Street 1:9535 RESEDA BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-2310
Practice Address - Country:US
Practice Address - Phone:818-709-6464
Practice Address - Fax:818-709-6419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53069122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty