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General NPI Number Information
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NPI Number | 1205108479
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Entity Type | Organization
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Legal Business Name | LILIT BAGHDASARIAN DDS A PROFESIONAL CORPORATION
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 5106 HOLLYWOOD BLVD 200
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City | LOS ANGELES
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State | CA
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Zip | 90027-6135
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Country | US
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Telephone | 323-667-9127
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Fax | 323-664-8320
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Provider Business Mailing Address
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Address Line | 5106 HOLLYWOOD BLVD 200
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City | LOS ANGELES
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State | CA
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Zip | 90027-6115
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Country | US
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Telephone | 323-667-9127
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Fax | 323-664-8320
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Authorized Official
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Title or Position | DENTIST
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Name | MRS. LILIT BAGDASARIAN
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Credential | D.D.S
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Telephone | 323-667-9127
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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 | 56096
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License Number State | CA
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