{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "LILIT BAGHDASARIAN DDS A PROFESIONAL CORPORATION",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5106 HOLLYWOOD BLVD",
"SecondLineMailingAddress": "200",
"MailingAddressCityName": "LOS ANGELES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90027-6115",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "323-667-9127",
"MailingAddressFaxNumber": "323-664-8320",
"FirstLinePracticeLocationAddress": "5106 HOLLYWOOD BLVD",
"SecondLinePracticeLocationAddress": "200",
"PracticeLocationAddressCityName": "LOS ANGELES",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90027-6135",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "323-667-9127",
"PracticeLocationAddressFaxNumber": "323-664-8320",
"EnumerationDate": "02/03/2012",
"LastUpdateDate": "07/08/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BAGDASARIAN",
"AuthorizedOfficialFirstName": "LILIT",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DENTIST",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S",
"AuthorizedOfficialTelephoneNumber": "323-667-9127",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "56096",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}