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General NPI Number Information
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NPI Number | 1336672369
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Entity Type | Individual
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Provider Name | DAIVA BARTULIS D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 04/06/2017
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Last Update Date | 04/06/2017
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Provider Practice Location Address
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Address Line | 8500 WILSHIRE BLVD. SUITE1004
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3102
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Country | US
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Telephone | 310-659-1510
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Fax |
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Provider Business Mailing Address
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Address Line | 4159 PUNTA ALTA DR
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City | LOS ANGELES
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State | CA
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Zip | 90008-1144
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Country | US
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Telephone | 310-940-5174
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Fax | 310-659-1302
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 47449
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License Number State | CA
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