MEDICARE: SARKIS A DAMARGI DDS, INC.

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
1	1223G0001X	General Practice Dentistry	42294	CA

General Provider Information

NPI Number	:	1073679189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARKIS A DAMARGI DDS, INC.

Provider Business Mailing Address
First Line	:	1004 S GLENDALE AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-2806
Country	:	US
Telephone Number	:	818-551-9515
Fax Number	:	818-551-9976

Provider Business Practice Location Address
First Line	:	1004 S GLENDALE AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-2806
Country	:	US
Telephone Number	:	818-551-9515
Fax Number	:	818-551-9976

Authorized Official
Title or Position	:	CEO
Name	:	DR. SARKIS AGOP DAMARGI
Credential	:	DDS
Telephone Number	:	818-551-9515

Provider Enumeration Date	:	01/01/2007
Last Update Date	:	10/26/2015

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