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NPI 1013626738

NPI 1013626738 : ASHLEY BAKSHIAN DDS : MONTEBELLO, CA

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General NPI Number Information
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    NPI Number           |    1013626738
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    Entity Type          |    Individual 
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    Provider Name        |    ASHLEY BAKSHIAN DDS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/21/2022
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    Last Update Date     |    11/21/2022
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Provider Practice Location Address
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    Address Line         |    2020 W WHITTIER BLVD 
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    City                 |    MONTEBELLO
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    State                |    CA
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    Zip                  |    90640-4011
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    Country              |    US
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    Telephone            |    323-720-1717
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    Fax                  |    323-720-9767
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Provider Business Mailing Address
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    Address Line         |    2020 W WHITTIER BLVD 
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    City                 |    MONTEBELLO
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    State                |    CA
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    Zip                  |    90640-4011
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    Country              |    US
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    Telephone            |    323-720-1717
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    Fax                  |    323-720-9767
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    108377
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    License Number State |    CA
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