Provider Demographics
NPI:1578282109
Name:MATIAN, DAVID SHERVIN (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:SHERVIN
Last Name:MATIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28632 ROADSIDE DR STE 270
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-6301
Mailing Address - Country:US
Mailing Address - Phone:818-706-6077
Mailing Address - Fax:
Practice Address - Street 1:28632 ROADSIDE DR STE 270
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-6301
Practice Address - Country:US
Practice Address - Phone:818-706-6077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1077951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty