Provider Demographics
NPI:1710069349
Name:NOUNEH, AYMAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:AYMAN
Middle Name:
Last Name:NOUNEH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 S SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-4366
Mailing Address - Country:US
Mailing Address - Phone:818-834-2858
Mailing Address - Fax:
Practice Address - Street 1:13682 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:PACOIMA
Practice Address - State:CA
Practice Address - Zip Code:91331-3616
Practice Address - Country:US
Practice Address - Phone:818-834-2858
Practice Address - Fax:818-834-2698
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA398551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice