MEDICARE: DR. ASTGIK AMY DEMIRCHYAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	101854	CA

General Provider Information

NPI Number	:	1225548035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASTGIK AMY DEMIRCHYAN DDS

Provider Business Mailing Address
First Line	:	10455 GLORY AVE
Second Line	:
City	:	TUJUNGA
State	:	CA
Zip	:	91042-2025
Country	:	US
Telephone Number	:	818-395-8133
Fax Number	:

Provider Business Practice Location Address
First Line	:	7738 FOOTHILL BLVD
Second Line	:
City	:	TUJUNGA
State	:	CA
Zip	:	91042-2121
Country	:	US
Telephone Number	:	818-352-8200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2017
Last Update Date	:	10/06/2017

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