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General NPI Number Information
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NPI Number | 1205627411
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Entity Type | Organization
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Legal Business Name | LA SMILES ENDODONTICS
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 23206 LYONS AVE STE 205
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City | SANTA CLARITA
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State | CA
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Zip | 91321-2672
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Country | US
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Telephone | 661-255-9589
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Fax | 661-255-5785
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Provider Business Mailing Address
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Address Line | 23206 LYONS AVE STE 205
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City | SANTA CLARITA
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State | CA
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Zip | 91321-2672
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Country | US
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Telephone | 661-255-9589
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Fax |
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Authorized Official
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Title or Position | OWNER/DDS
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Name | DR. KRISTINA SHAGRAMANOVA
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Credential | DDS INC
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Telephone | 661-255-9589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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