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General NPI Number Information
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NPI Number | 1528849759
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Entity Type | Organization
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Legal Business Name | JACK A. BAYRAMYAN DDS INC
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 18607 VENTURA BLVD STE 209
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City | TARZANA
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State | CA
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Zip | 91356-4171
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Country | US
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Telephone | 818-578-8665
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Fax |
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Provider Business Mailing Address
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Address Line | 5744 SAN FERNANDO RD STE 202
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City | GLENDALE
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State | CA
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Zip | 91202-2181
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Country | US
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Telephone | 702-900-5005
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JACK A BAYRAMYAN
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Credential | DDS
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Telephone | 818-629-4004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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