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General NPI Number Information
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NPI Number | 1780331488
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Entity Type | Organization
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Legal Business Name | B. DEIRMENJIAN, D.D.S., INC.
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Dates
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Enumeration Date | 03/03/2022
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Last Update Date | 03/03/2022
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Provider Practice Location Address
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Address Line | 8320 DE SOTO AVE
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City | CANOGA PARK
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State | CA
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Zip | 91304-2701
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Country | US
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Telephone | 818-883-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 12640 HESPERIA RD STE A
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City | VICTORVILLE
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State | CA
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Zip | 92395-7753
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Country | US
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Telephone | 760-241-3336
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | BAROUIR ARSHAG DEIRMENJIAN
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Credential |
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Telephone | 310-497-2211
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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 |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #5
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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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