Provider Demographics
NPI:1144614124
Name:GHARIBIAN DENTAL, INC.
Entity type:Organization
Organization Name:GHARIBIAN DENTAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DINO
Authorized Official - Middle Name:
Authorized Official - Last Name:GHARIBIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-281-3122
Mailing Address - Street 1:923 E PALM AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91501-1410
Mailing Address - Country:US
Mailing Address - Phone:818-281-3122
Mailing Address - Fax:
Practice Address - Street 1:500 E OLIVE AVE STE 440
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91501-2171
Practice Address - Country:US
Practice Address - Phone:818-281-3122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA606651223G0001X
CA593451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty