=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124410683
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HILLTOP DENTAL OFFICE OF GEORGE APELIAN, DDS INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/20/2015
-----------------------------------------------------
Last Update Date | 02/20/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 30300 AGOURA RD. STE 230
-----------------------------------------------------
City | AGOURA HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-865-8651
-----------------------------------------------------
Fax | 818-865-8647
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 30300 AGOURA RD. STE 230
-----------------------------------------------------
City | AGOURA HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-865-8651
-----------------------------------------------------
Fax | 818-865-8647
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST/OWNER
-----------------------------------------------------
Name | MR. GEORGE BEDROS APELIAN
-----------------------------------------------------
Credential | D.D.S.
-----------------------------------------------------
Telephone | 818-865-8651
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 29549
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------