Healthcare Provider Details

I. General information

NPI: 1831452044
Provider Name (Legal Business Name): RUZAN SARKISSIAN DDS.INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 06/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14200 VENTURA BLVD 201
SHERMAN OAKS CA
91423-2741
US

IV. Provider business mailing address

14200 VENTURA BLVD SUITE 201
SHERMAN OAKS CA
91423-2741
US

V. Phone/Fax

Practice location:
  • Phone: 818-788-8131
  • Fax:
Mailing address:
  • Phone: 818-788-8131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number52465
License Number StateCA

VIII. Authorized Official

Name: DR. RUZAN SARKISSIAN
Title or Position: OWNER
Credential: DDS
Phone: 818-788-8131