Provider Demographics
NPI:1760624977
Name:YERVANT G ASLANIAN, DDS, MD
Entity Type:Organization
Organization Name:YERVANT G ASLANIAN, DDS, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BILEMDJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-247-3317
Mailing Address - Street 1:418 E GLENOAKS BLVD
Mailing Address - Street 2:#204
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91207-4283
Mailing Address - Country:US
Mailing Address - Phone:818-247-3317
Mailing Address - Fax:818-247-0635
Practice Address - Street 1:418 E GLENOAKS BLVD
Practice Address - Street 2:#204
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91207-4283
Practice Address - Country:US
Practice Address - Phone:818-247-3317
Practice Address - Fax:818-247-0635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA391301223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H83239Medicare UPIN
CAH03498Medicare UPIN