Healthcare Provider Details

I. General information

NPI: 1144697293
Provider Name (Legal Business Name): ARAM GRIGORYAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2015
Last Update Date: 04/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9146 SEPULVEDA BLVD STE A
NORTH HILLS CA
91343-6948
US

IV. Provider business mailing address

9146 SEPULVEDA BLVD STE A
NORTH HILLS CA
91343-6948
US

V. Phone/Fax

Practice location:
  • Phone: 818-830-7000
  • Fax:
Mailing address:
  • Phone: 818-830-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number64956
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: