Provider Demographics
NPI:1982836722
Name:KOTCHOUNIAN, TALINE ANNIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:TALINE
Middle Name:ANNIE
Last Name:KOTCHOUNIAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12265 VENTURA BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2532
Mailing Address - Country:US
Mailing Address - Phone:818-538-8899
Mailing Address - Fax:
Practice Address - Street 1:12265 VENTURA BLVD STE 208
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-2532
Practice Address - Country:US
Practice Address - Phone:818-538-8899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-12
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58653122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist