1396624912 NPI number — SONA ASATRYAN DDS PROFESSIONAL CORP

Table of content: MRS. ANHUE THI DOAN RPH (NPI 1104030543)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396624912 NPI number — SONA ASATRYAN DDS PROFESSIONAL CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SONA ASATRYAN DDS PROFESSIONAL CORP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396624912
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 S FAIR OAKS AVE STE 206
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PASADENA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91105-2536
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-431-2654
Provider Business Mailing Address Fax Number:
626-431-2811

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 S FAIR OAKS AVE STE 206
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PASADENA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91105-2536
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-431-2654
Provider Business Practice Location Address Fax Number:
626-431-2811
Provider Enumeration Date:
08/28/2025

Additional Information

Authorized Official

Authorized Official Last Name:
ASATRYAN
Authorized Official First Name:
SONA
Authorized Official Middle Name:
Authorized Official Title or Position:
DENTIST
Authorized Official Telephone Number:
626-431-2654

Provider Taxonomy Codes

  • Taxonomy code: 122300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1114252384 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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