Provider Demographics
NPI:1023296985
Name:TERPOGHOSSIAN DENTAL GROUP INC.
Entity type:Organization
Organization Name:TERPOGHOSSIAN DENTAL GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VARTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TER POGHOSSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-913-5030
Mailing Address - Street 1:125 E GLENOAKS BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91207-2131
Mailing Address - Country:US
Mailing Address - Phone:818-246-3736
Mailing Address - Fax:818-549-9904
Practice Address - Street 1:125 E GLENOAKS BLVD STE 103
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91207-2131
Practice Address - Country:US
Practice Address - Phone:818-246-3736
Practice Address - Fax:818-549-9904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-03
Last Update Date:2008-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA560171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty