Provider Demographics
NPI:1588016570
Name:PILOSYAN, TATEVIK (DDS)
Entity Type:Individual
Prefix:DR
First Name:TATEVIK
Middle Name:
Last Name:PILOSYAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 N PECOS RD STE B
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7330
Mailing Address - Country:US
Mailing Address - Phone:725-500-8250
Mailing Address - Fax:
Practice Address - Street 1:54 N PECOS RD STE B
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7330
Practice Address - Country:US
Practice Address - Phone:725-500-8250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100310122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist