Healthcare Provider Details

I. General information

NPI: 1316271422
Provider Name (Legal Business Name): TOROSSIAN ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2009
Last Update Date: 09/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 N PACIFIC AVE STE 202
GLENDALE CA
91202-4317
US

IV. Provider business mailing address

3685 STARTOUCH DR
PASADENA CA
91107-1337
US

V. Phone/Fax

Practice location:
  • Phone: 626-422-9561
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number58469
License Number StateCA

VIII. Authorized Official

Name: DR. GILDA TOROSSIAN
Title or Position: ORTHODONTIST
Credential: DDS, MSD
Phone: 818-956-3200