Provider Demographics
NPI:1609246792
Name:HACOPIAN, NINETTE (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:NINETTE
Middle Name:
Last Name:HACOPIAN
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:859 N FAIR OAKS AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-3078
Mailing Address - Country:US
Mailing Address - Phone:626-765-6104
Mailing Address - Fax:626-765-9760
Practice Address - Street 1:859 N FAIR OAKS AVE STE 120
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-3078
Practice Address - Country:US
Practice Address - Phone:626-765-6104
Practice Address - Fax:626-765-9760
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA630971223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics