Provider Demographics
NPI:1013079417
Name:BARNARD NAGAI DDS INC
Entity Type:Organization
Organization Name:BARNARD NAGAI DDS INC
Other - Org Name:LAUREL CANYON DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARNARD
Authorized Official - Middle Name:GOWICHI
Authorized Official - Last Name:NAGAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-764-5333
Mailing Address - Street 1:6700 LAUREL CANYON BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606
Mailing Address - Country:US
Mailing Address - Phone:818-764-5333
Mailing Address - Fax:818-765-0887
Practice Address - Street 1:6700 LAUREL CANYON BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606
Practice Address - Country:US
Practice Address - Phone:818-764-5333
Practice Address - Fax:818-765-0887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39850122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB3985002OtherDENTICAL