Provider Demographics
NPI:1558056234
Name:GOR BARSEGHYAN, DMD, APC
Entity Type:Organization
Organization Name:GOR BARSEGHYAN, DMD, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GOR
Authorized Official - Middle Name:
Authorized Official - Last Name:BARSEGHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:818-624-1411
Mailing Address - Street 1:372 E OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1215
Mailing Address - Country:US
Mailing Address - Phone:818-450-5000
Mailing Address - Fax:818-736-5002
Practice Address - Street 1:372 E OLIVE AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1215
Practice Address - Country:US
Practice Address - Phone:818-450-5000
Practice Address - Fax:818-736-5002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental