Provider Demographics
NPI:1487224416
Name:GOEL, ARYA SEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARYA
Middle Name:SEAN
Last Name:GOEL
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 1:16101 VENTURA BLVD STE 329
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2516
Mailing Address - Country:US
Mailing Address - Phone:818-876-2103
Mailing Address - Fax:
Practice Address - Street 1:16101 VENTURA BLVD STE 329
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2516
Practice Address - Country:US
Practice Address - Phone:818-876-2103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1063501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice