Provider Demographics
NPI:1700457975
Name:YOMTOUBIAN, JONATHAN NATHANEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:NATHANEL
Last Name:YOMTOUBIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 S CARSON RD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2904
Mailing Address - Country:US
Mailing Address - Phone:310-402-1496
Mailing Address - Fax:
Practice Address - Street 1:206 S CARSON RD
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2904
Practice Address - Country:US
Practice Address - Phone:310-402-1496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106241122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist