Provider Demographics
NPI:1598093130
Name:MINASYAN D.D.S. INC
Entity Type:Organization
Organization Name:MINASYAN D.D.S. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TER-MINASYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-436-2950
Mailing Address - Street 1:924 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-5338
Mailing Address - Country:US
Mailing Address - Phone:562-436-2950
Mailing Address - Fax:562-437-3161
Practice Address - Street 1:924 E BROADWAY
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-5338
Practice Address - Country:US
Practice Address - Phone:562-436-2950
Practice Address - Fax:562-437-3161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty