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General NPI Number Information
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NPI Number | 1801459516
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Entity Type | Organization
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Legal Business Name | EDWIN BABADJANIAN DDS APC
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Dates
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Enumeration Date | 04/18/2019
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Last Update Date | 07/26/2019
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Provider Practice Location Address
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Address Line | 1101 N PACIFIC AVE STE 206
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City | GLENDALE
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State | CA
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Zip | 91202-4367
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Country | US
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Telephone | 818-548-5544
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Fax | 888-374-8024
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Provider Business Mailing Address
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Address Line | 1101 N PACIFIC AVE STE 206
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City | GLENDALE
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State | CA
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Zip | 91202-4367
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Country | US
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Telephone | 818-548-5544
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Fax | 888-374-8024
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Authorized Official
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Title or Position | OWNER
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Name | EDWIN BABADJANIAN
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Credential | DDS
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Telephone | 818-468-5186
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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 | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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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 | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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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 | 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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