15719 Vanowen St Dental Group of Yeghisheh Mirzoyan DDS Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

15719 VANOWEN ST DENTAL GROUP OF YEGHISHEH MIRZOYAN DDS INC

Practice address

15719 Vanowen St
Van Nuys, CA 91406-5030

Phone

(818) 419-0047

NPI assigned

May 23, 2023

Last updated

May 23, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yeghisheh Mirzoyan, D.D.S.NPI 1497156038

Title

President

Phone

(818) 927-3113

Specialties & licenses 2

Addresses

Other names 1

• 15719 Vanowen St dental group of Yeghisheh Mirzoyan DDS INC Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yeghisheh Mirzoyan, D.D.S.

  • Dentist
  • Van Nuys, CA
  • NPI 1497156038
  NPD Authorized official

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684800000000",
    "number": "1558053025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6440 GREENBUSH AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914011839",
            "telephone_number": "818-419-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15719 VANOWEN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914065030",
            "telephone_number": "818-419-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "15719 VANOWEN ST DENTAL GROUP OF YEGHISHEH MIRZOYAN DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A",
        "authorized_official_last_name": "MIRZOYAN",
        "authorized_official_first_name": "YEGHISHEH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-927-3113",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "15719 Vanowen St dental group of Yeghisheh Mirzoyan DDS INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Dental Clinic/Center in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.