Kouyoumdjian, Raffy

Kouyoumdjian, Raffy is an individual health care provider with primary practice located at 2482 Jacksboro Hwy , Ft Worth TX 76114-2201. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / Dentist is his primary health care specialty. Kouyoumdjian, Raffy can be contacted via phone (817) 626-4867.

Contact Information

Primary practice address
2482 Jacksboro Hwy Ft Worth TX 76114-2201
Phone: (817) 626-4867
Fax: (817) 626-4866
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 23066 Texas
Dental Providers / General Practice 1223G0001X 23066 Texas

Profile Details

NPI number 1780705483
LBN Legal business name Kouyoumdjian, Raffy
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 2nd, 2007
Last updated Oct 25th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780705483 NPPES
Texas MEDICAID 1479404-03
Texas MEDICAID 1479404-06
Texas MEDICAID 1479404-08
Texas MEDICAID 1479404-04
Texas MEDICAID 1479404-09
Texas MEDICAID 1479404-12
Texas MEDICAID 1479404-07
Texas MEDICAID 1479404-11
Texas MEDICAID 1479404-10
Texas MEDICAID 1479404-05
Texas MEDICAID 1824195-02
Texas MEDICAID 1479404-01

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