Provider Demographics
NPI:1669146684
Name:SHAHANGIAN DENTAL CORP.
Entity type:Organization
Organization Name:SHAHANGIAN DENTAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:BITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHANGIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-508-7300
Mailing Address - Street 1:4821 LANKERSHIM BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-4572
Mailing Address - Country:US
Mailing Address - Phone:818-508-7300
Mailing Address - Fax:818-301-2566
Practice Address - Street 1:4821 LANKERSHIM BLVD STE B
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-4572
Practice Address - Country:US
Practice Address - Phone:818-508-7300
Practice Address - Fax:818-301-2566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental