Healthcare Provider Details

I. General information

NPI: 1659430908
Provider Name (Legal Business Name): DARREL R DAGDIGIAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16406 E WHITTIER BLVD
WHITTIER CA
90603-3043
US

IV. Provider business mailing address

16406 WHITTIER BLVD
WHITTIER CA
90603-3043
US

V. Phone/Fax

Practice location:
  • Phone: 562-694-0396
  • Fax:
Mailing address:
  • Phone: 562-694-0396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number27262
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: