FERNANDEZ-POBLETE DENTAL CORPORATION (NPI# 1598806614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598806614 |
| Entity Type | Organization |
| Organization Name | FERNANDEZ-POBLETE DENTAL CORPORATION |
| Other Organization Name | VICTORY DENTAL CARE |
| Practice Address |
11631 Victory Blvd Ste 102 North Hollywood CA 91606-3572 |
| Practice Telephone | 8187663660 |
| Mailing Telephone | 8187663660 |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. EDITHA PASCUAL POBLETE (DENTIST) |
| Authorized Official Telephone | 8187663660 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
47993 | CA | Dental Providers |
| Other Name | Type Code |
|---|---|
| Victory Dental Care | Doing Business As Name - Organization |
| Street Address |
11631 VICTORY BLVD STE 102 |
| City | NORTH HOLLYWOOD |
| State | CA |
| Zip Code | 91606-3572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972113355 | Marine Mary Kademyan | Nurse Practitioner | 6528 Babcock Ave, North Hollywood, CA 91606 | 2020-07-31 |
| 1306322409 | Ally Home Health, Inc. | Home Health | 12801 Victory Blvd, N Hollywood, CA 91606 | 2018-07-12 |
| 1083133730 | Amanda Kardonskiy | Counselor | 12821 Victory Blvd., North Hollywood, CA 91606 | 2017-09-13 |
| 1740719020 | Christian Quijano | Case Manager/Care Coordinator | 6736 Laurel Cyn. Blvd., Suite 200, North Hollywood, CA 91606 | 2017-06-08 |
| 1972032308 | Luis Angel Estrada | Rehabilitation Practitioner | 6736 Laurel Canyon Blvd. Unit 200, North Hollywood, CA 91606 | 2017-06-08 |
| 1003342262 | Mint Services | Medical Genetics | 12183 Victory Blvd, North Hollywood, CA 91606 | 2017-05-10 |
| 1912362443 | Paronian Medical Group, Inc. | Legal Medicine | 11631 Victory Blvd., Suite 105, North Hollywood, CA 91606 | 2015-12-29 |
| 1811364755 | Haig Mastikian | Dentist | 10835 Oxnard St, North Hollywood, CA 91606 | 2015-08-26 |
| 1962895805 | Jam Sports Inc | Clinic/Center | 12813 Victory Blvd, North Hollywood, CA 91606 | 2015-03-17 |
| 1750642880 | Heidi Raquel Donaire | Marriage & Family Therapist | 6736 Laurel Canyon Blvd., Ste. 200, North Hollywood, CA 91606 | 2012-06-05 |
| Find all providers in zip 91606 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811364755 | Haig Mastikian | Dentist | 10835 Oxnard St, North Hollywood, CA 91606 | 2015-08-26 |
| 1962898072 | Delakyan Dds & Hartounian Dmd Inc | Dentist | 4444 Lankershim Blvd Ste 110, North Hollywood, CA 91602-2346 | 2015-04-15 |
| 1811399306 | Rosemarie Acevedo | Dentist | 11559 Sherman Way Unit 100, North Hollywood, CA 91605-5883 | 2014-09-16 |
| 1861825895 | Steven Robert Spivak | Dentist | 13114 Sherman Way, North Hollywood, CA 91605-4645 | 2013-08-13 |
| 1306187430 | Bellingham Dental Group Inc Dr Roland Yakubov | Dentist | 6430 Bellingham Ave, North Hollywood, CA 91606-1402 | 2013-03-14 |
| 1114252384 | Sona Asatryan | Dentist | 10932 Morrison St, #116, North Hollywood, CA 91601-5111 | 2009-10-06 |
| 1023268513 | Roland Yakubov | Dentist | 6428 Bellingham Ave, North Hollywood, CA 91606-1402 | 2008-09-22 |
| 1912163692 | Michelle Duong | Dentist | 11404 Victory Blvd, North Hollywood, CA 91606 | 2008-08-01 |
| 1790963577 | Martha Patricia Parroquin | Dentist | 12632 Welby Way, North Hollywood, CA 91606-1212 | 2008-02-05 |
| 1669675377 | Melisa Hernandez | Dentist | 12120 Saticoy St, Suite C., North Hollywood, CA 91605-3055 | 2007-06-08 |
| Find all providers in NORTH HOLLYWOOD | ||||
| City | NORTH HOLLYWOOD |
| Zip Code | 91606 |
Please comment or provide details below to improve the information on FERNANDEZ-POBLETE DENTAL CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.