Provider Demographics
NPI:1770728511
Name:ALMASI, GOURGEN (DDS)
Entity type:Individual
Prefix:MR
First Name:GOURGEN
Middle Name:
Last Name:ALMASI
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 1:290 E VERDUGO AVE
Mailing Address - Street 2:208
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1300
Mailing Address - Country:US
Mailing Address - Phone:818-566-8859
Mailing Address - Fax:818-861-7426
Practice Address - Street 1:290 E VERDUGO AVE
Practice Address - Street 2:208
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1300
Practice Address - Country:US
Practice Address - Phone:818-566-8859
Practice Address - Fax:818-861-7426
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36332122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist