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General NPI Number Information
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NPI Number | 1952536245
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Entity Type | Individual
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Provider Name | SUSAN JENNY JARAKIAN DDS
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Gender | Female
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Dates
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Enumeration Date | 05/15/2009
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Last Update Date | 05/15/2009
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Provider Practice Location Address
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Address Line | 11239 TAMPA AVE STE 208
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City | NORTHRIDGE
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State | CA
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Zip | 91326-3783
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Country | US
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Telephone | 818-368-6266
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Fax |
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Provider Business Mailing Address
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Address Line | 19645 WEEBURN LN
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City | TARZANA
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State | CA
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Zip | 91356-5439
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Country | US
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Telephone | 818-648-7240
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Fax |
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 55032
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License Number State | CA
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