Provider Demographics
NPI:1821166075
Name:OGANESYAN, ARSEN (DDS)
Entity Type:Individual
Prefix:
First Name:ARSEN
Middle Name:
Last Name:OGANESYAN
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 1:11516 OXNARD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-4810
Mailing Address - Country:US
Mailing Address - Phone:818-769-9551
Mailing Address - Fax:818-769-2131
Practice Address - Street 1:11516 OXNARD ST
Practice Address - Street 2:
Practice Address - City:N HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-4810
Practice Address - Country:US
Practice Address - Phone:818-769-9551
Practice Address - Fax:818-769-2131
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB417661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice