Provider Demographics
NPI:1609232719
Name:ZARABIAN AND KOHANOF FOOTHILL DDS DENTAL CORP
Entity Type:Organization
Organization Name:ZARABIAN AND KOHANOF FOOTHILL DDS DENTAL CORP
Other - Org Name:FOOTHILL DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARABIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-353-1123
Mailing Address - Street 1:15300 DEVONSHIRE ST STE 6
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-2758
Mailing Address - Country:US
Mailing Address - Phone:818-894-6411
Mailing Address - Fax:
Practice Address - Street 1:6581 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-2728
Practice Address - Country:US
Practice Address - Phone:818-353-1123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61479122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty