Provider Demographics
NPI:1821485350
Name:SONA GEORGIAN D.D.S INC.
Entity Type:Organization
Organization Name:SONA GEORGIAN D.D.S INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SONA
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-991-4664
Mailing Address - Street 1:32144 AGOURA RD STE 213
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4054
Mailing Address - Country:US
Mailing Address - Phone:818-991-4664
Mailing Address - Fax:818-991-4665
Practice Address - Street 1:32144 AGOURA RD STE 213
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-4054
Practice Address - Country:US
Practice Address - Phone:818-991-4664
Practice Address - Fax:818-991-4665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51255261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center