Provider Demographics
NPI:1760636484
Name:MKHEYAN, NUNE (DDS)
Entity Type:Individual
Prefix:
First Name:NUNE
Middle Name:
Last Name:MKHEYAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8676 LINDLEY AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-3318
Mailing Address - Country:US
Mailing Address - Phone:818-700-0000
Mailing Address - Fax:818-700-0030
Practice Address - Street 1:8676 LINDLEY AVE.
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-3318
Practice Address - Country:US
Practice Address - Phone:818-700-0000
Practice Address - Fax:818-700-0030
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA536281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice