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NPI Code Detail

MEDICARE: DR. MARINE MARTIROSYAN DDS

MEDICARE:  DR. MARINE  MARTIROSYAN  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist43639CA

General Provider Information

NPI Number : 1033287636
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARINE MARTIROSYAN DDS
Provider Business Mailing Address
First Line : 532 W GLENOAKS BLVD
Second Line :
City : GLENDALE
State : CA
Zip : 91202-2813
Country : US
Telephone Number : 818-396-7777
Fax Number : 818-553-1433
Provider Business Practice Location Address
First Line : 532 W GLENOAKS BLVD
Second Line :
City : GLENDALE
State : CA
Zip : 91202-2813
Country : US
Telephone Number : 818-396-7777
Fax Number : 818-553-1433
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2006
Last Update Date : 11/11/2025

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Directions to “ DR. MARINE MARTIROSYAN DDS” Practice Location

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