Healthcare Provider Details
I. General information
NPI: 1700740453
Provider Name (Legal Business Name): LIANNA DAMARGI, DDS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2650 GRIFFITH PARK BLVD
LOS ANGELES CA
90039-2520
US
IV. Provider business mailing address
2650 GRIFFITH PARK BLVD
LOS ANGELES CA
90039-2520
US
V. Phone/Fax
- Phone: 323-660-5522
- Fax:
- Phone: 323-660-5522
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LIANNA
DAMARGI
Title or Position: DENTIST
Credential: DDS
Phone: 323-660-5522