Healthcare Provider Details

I. General information

NPI: 1346458114
Provider Name (Legal Business Name): RAFIK MESERKHANI & YVETTE M GULESSERIAN D.D.S INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 10/07/2022
Certification Date: 10/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E OLIVE AVE
BURBANK CA
91501-3316
US

IV. Provider business mailing address

633 N CENTRAL AVE STE 204
GLENDALE CA
91203-1817
US

V. Phone/Fax

Practice location:
  • Phone: 818-846-6464
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number45734
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RAFIK RAYMOND MESERKHANI
Title or Position: OWNER
Credential: D.D.S
Phone: 818-549-0994