Evazyan Dental Corp

Primary specialty

DentistTaxonomy code 122300000X

License

43949 Issued in CA

Legal business name

EVAZYAN DENTAL CORP

Practice address

12143 Magnolia Blvd
Valley Village, CA 91607-2609

Phone

(818) 506-0100

Fax

(818) 506-0700

NPI assigned

Dec 12, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Benita Evazyan, DMDNPI 1144420795

Title

Dentist

Phone

(818) 506-0100

Specialties & licenses 2

Addresses

Other names 1

• Magnolia Gentle Dentistry Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benita Evazyan, DMD

  • Dentist
  • Valley Village, CA
  • NPI 1144420795
  NPD (past) Authorized official
• Rita Evazyan

  • Dentist
  • Culver City, CA
  • NPI 1568662617
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346716800000",
    "number": "1104987445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12143 MAGNOLIA BLVD",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916072609",
            "telephone_number": "818-506-0100",
            "fax_number": "818-506-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12143 MAGNOLIA BLVD",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916072609",
            "telephone_number": "818-506-0100",
            "fax_number": "818-506-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVAZYAN DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2012-09-04",
        "status": "A",
        "authorized_official_last_name": "EVAZYAN",
        "authorized_official_first_name": "BENITA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "818-506-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "47472",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "43949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Gentle Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Equilogic Systems, Inc.
• Equitable Connections to Housing Opportunities (Echo)
• ER Hospice Care Inc
• Veronica Erzeroumian, M.A.
• Gabriella Yvonne Esquilin
• Benita Evazyan, DMD
• Evercare at Home
• Excellerated Home Health, Inc.
• Kimia Faghihi, D.C.
• Marc Fajardo

• Dentist in Valley Village, CA
• Providers in Valley Village, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.