Provider Demographics
NPI:1427542398
Name:NAIRI KUREGHIAN, D.D.S., INC
Entity Type:Organization
Organization Name:NAIRI KUREGHIAN, D.D.S., INC
Other - Org Name:NAIRI KUREGHIAN, D.D.S., INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NAIRI
Authorized Official - Middle Name:
Authorized Official - Last Name:KUREGHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-701-6197
Mailing Address - Street 1:18250 ROSCOE BLVD STE 355
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-4287
Mailing Address - Country:US
Mailing Address - Phone:818-701-6197
Mailing Address - Fax:818-701-6198
Practice Address - Street 1:18250 ROSCOE BLVD STE 355
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4287
Practice Address - Country:US
Practice Address - Phone:818-701-6197
Practice Address - Fax:818-701-6198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41636261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental