Provider Demographics
NPI:1447462114
Name:M ABRAMOVICI & S NOURIAN D.D.S. INC.
Entity type:Organization
Organization Name:M ABRAMOVICI & S NOURIAN D.D.S. INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHRAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:NOURIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-693-8202
Mailing Address - Street 1:14564 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2129
Mailing Address - Country:US
Mailing Address - Phone:562-693-8202
Mailing Address - Fax:562-693-2893
Practice Address - Street 1:14564 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2129
Practice Address - Country:US
Practice Address - Phone:562-693-8202
Practice Address - Fax:562-693-2893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA323731223G0001X
CA350511223G0001X
CA492841223G0001X
CA501211223P0300X
CAOMS 621223S0112X
CA203821223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty