MEDICARE: DR. MARK DEUKMEDJIAN D.D.S., M.S.D.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	43778	CA

General Provider Information

NPI Number	:	1992831812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK DEUKMEDJIAN D.D.S., M.S.D.

Provider Business Mailing Address
First Line	:	12018 LOUISE AVE
Second Line	:
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-2450
Country	:	US
Telephone Number	:	818-723-9015
Fax Number	:

Provider Business Practice Location Address
First Line	:	11155 TAMPA AVE
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91326-2254
Country	:	US
Telephone Number	:	818-360-3636
Fax Number	:	818-363-4002

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1386754232 — MOBILE RADIOLOGICAL SERVICES, INC
Practice Location Address:

11177 TAMPA AVE. , SUITE B
NORTHRIDGE, CA
91326-2254

Practice Phone: 818-366-0474
Practice Fax: 818-474-7530

1134253693 — DR. MICHAEL VAROUJAN TERZIAN O.D.
Practice Location Address:

11151 TAMPA AVE
NORTHRIDGE, CA
91326-2254

Practice Phone: 818-366-9664
Practice Fax: 818-368-5314

1043438773 — DR. TAM-HUONG NGOC TRAN DDS
Practice Location Address:

11155 TAMPA AVE
NORTHRIDGE, CA
91326-2254

Practice Phone: 818-363-3382
Practice Fax: 818-363-4002

1538466651 — ADVANCE PAIN MANAGEMENT GROUP
Practice Location Address:

11177 TAMPA AVE. , SUITE B
NORTHRIDGE, CA
91326-2254

Practice Phone: 818-366-0474
Practice Fax: 818-474-7530

1336496587 — MICHAEL V. TERZIAN, O.D., A PROFESSIONAL CORPORATION
Practice Location Address:

11151 TAMPA AVE
NORTHRIDGE, CA
91326-2254

Practice Phone: 818-366-9664
Practice Fax: 818-368-5314

1831435346 — CERES MEDICAL SERVICES INC.
Practice Location Address:

11177 TAMPA AVE , SUITE #B
NORTHRIDGE, CA
91326-2254

Practice Phone: 818-366-4512
Practice Fax: 818-360-6319

Directions to “ DR. MARK DEUKMEDJIAN D.D.S., M.S.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.