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General NPI Number Information
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NPI Number | 1023993052
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Entity Type | Organization
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Legal Business Name | JIL-AGOPIAN KIRIKIAN MOURADIAN PROFESSIONAL DENTAL CORPORATION
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Dates
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Enumeration Date | 08/08/2025
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 4787 SANTA MONICA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90029-2631
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Country | US
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Telephone | 323-831-1190
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Fax |
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Provider Business Mailing Address
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Address Line | 17974 BORIS DR
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City | ENCINO
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State | CA
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Zip | 91316-4347
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Country | US
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Telephone | 818-458-9628
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARA JIL-AGOPIAN
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Credential | DDS
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Telephone | 818-458-9628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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