Provider Demographics
NPI:1669247094
Name:HUNANYAN DENTAL CORPORATION
Entity type:Organization
Organization Name:HUNANYAN DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LUSINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:818-636-8055
Mailing Address - Street 1:1328 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-1530
Mailing Address - Country:US
Mailing Address - Phone:818-636-8055
Mailing Address - Fax:
Practice Address - Street 1:2815 W SUNSET BLVD STE 106
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-2168
Practice Address - Country:US
Practice Address - Phone:213-380-2008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty