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General NPI Number Information
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NPI Number | 1083338818
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Entity Type | Organization
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Legal Business Name | MOURADIAN DMD & KIRIKIAN DDS, A PROFESSIONAL DENTAL CORPORATION
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 09/26/2022
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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 | 323-807-2527
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Fax |
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Provider Business Mailing Address
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Address Line | 701 N BRAND BLVD STE 820
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City | GLENDALE
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State | CA
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Zip | 91203-1283
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Country | US
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Telephone | 323-807-2527
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. VICTORIA MOURADIAN
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Credential | DMD
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Telephone | 323-807-2527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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