Provider Demographics
NPI:1801207527
Name:GOURGEN ALMASI DDS A PROFFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:GOURGEN ALMASI DDS A PROFFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT (OWNER)
Authorized Official - Prefix:DR
Authorized Official - First Name:GOURGEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMASI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-566-8859
Mailing Address - Street 1:290 E VERDUGO AVE
Mailing Address - Street 2:SUITE208
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:290 E VERDUGO AVE
Practice Address - Street 2:SUITE208
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1300
Practice Address - Country:US
Practice Address - Phone:818-566-8859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-15
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty