Healthcare Provider Details

I. General information

NPI: 1215123591
Provider Name (Legal Business Name): NARINE DANIELIAN DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2007
Last Update Date: 09/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4406 W MAGNOLIA BLVD STE A
BURBANK CA
91505-2729
US

IV. Provider business mailing address

4406 W MAGNOLIA BLVD STE A
BURBANK CA
91505-2729
US

V. Phone/Fax

Practice location:
  • Phone: 818-260-0274
  • Fax: 818-260-8743
Mailing address:
  • Phone: 818-260-0274
  • Fax: 818-260-8743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number49867
License Number StateCA

VIII. Authorized Official

Name: DR. NARINE DANIELIAN
Title or Position: PRESIDENT
Credential: DDS
Phone: 818-260-0274