Provider Demographics
NPI:1821300690
Name:CARMEN OHANIAN DDS INC
Entity Type:Organization
Organization Name:CARMEN OHANIAN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:OHANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-244-0215
Mailing Address - Street 1:1110 N BRAND BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2567
Mailing Address - Country:US
Mailing Address - Phone:818-244-0215
Mailing Address - Fax:818-244-0267
Practice Address - Street 1:1110 N BRAND BLVD STE 201
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2567
Practice Address - Country:US
Practice Address - Phone:818-244-0215
Practice Address - Fax:818-244-0267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-09
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA407011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty