Provider Demographics
NPI:1679321293
Name:TALIN GOLNAZARIAN DDS INC
Entity type:Organization
Organization Name:TALIN GOLNAZARIAN DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:TALIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLNAZARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-640-4096
Mailing Address - Street 1:5363 BALBOA BLVD STE 533
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-2849
Mailing Address - Country:US
Mailing Address - Phone:818-784-2002
Mailing Address - Fax:
Practice Address - Street 1:5363 BALBOA BLVD STE 533
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-2849
Practice Address - Country:US
Practice Address - Phone:818-784-2002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-08
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty