Provider Demographics
NPI:1770113029
Name:KARINEH AVANESS DMD INC
Entity type:Organization
Organization Name:KARINEH AVANESS DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARINEH
Authorized Official - Middle Name:
Authorized Official - Last Name:AVANESS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:818-471-5231
Mailing Address - Street 1:4955 VAN NUYS BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1820
Mailing Address - Country:US
Mailing Address - Phone:818-471-5231
Mailing Address - Fax:
Practice Address - Street 1:4955 VAN NUYS BLVD STE 202
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1820
Practice Address - Country:US
Practice Address - Phone:818-471-5231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental