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General NPI Number Information
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NPI Number | 1780578799
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Entity Type | Organization
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Legal Business Name | LILIT BAGDASARIAN DDS A PROFETIONAL CORPORATION
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 5106 HOLLYWOOD BLVD STE 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 |
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Provider Business Mailing Address
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Address Line | 5106 HOLLYWOOD BLVD
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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 |
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Authorized Official
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Title or Position | CEO
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Name | LILIT BAGDASARIAN
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Credential | DDS
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Telephone | 818-445-4286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State |
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