Provider Demographics
NPI:1750950887
Name:TIGRAN GYOKCHYAN DDS INC
Entity type:Organization
Organization Name:TIGRAN GYOKCHYAN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIGRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GYOKCHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-747-9670
Mailing Address - Street 1:1209 N HOLLYWOOD WAY # 100
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2224
Mailing Address - Country:US
Mailing Address - Phone:818-747-9670
Mailing Address - Fax:
Practice Address - Street 1:1209 N HOLLYWOOD WAY # 100
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2224
Practice Address - Country:US
Practice Address - Phone:818-747-9670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty