Provider Demographics
NPI:1891573135
Name:PAHLEDENT LLC
Entity Type:Organization
Organization Name:PAHLEDENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:TYGRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAHLEVANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-256-7355
Mailing Address - Street 1:8126 S MINGO RD STE 105
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-4578
Mailing Address - Country:US
Mailing Address - Phone:918-663-5538
Mailing Address - Fax:918-627-9985
Practice Address - Street 1:8126 S MINGO RD STE 105
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-4578
Practice Address - Country:US
Practice Address - Phone:918-663-5538
Practice Address - Fax:918-627-9985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental