Basic Information
| Provider Information | |||||||||
| NPI: | 1225097215 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEIRMENJIAN | ||||||||
| FirstName: | BAROUIR | ||||||||
| MiddleName: | ARSHAG | ||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15643 SHERMAN WAY | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | VAN NUYS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914067652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8557053434 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 15448 E AMAR RD | ||||||||
| Address2: | |||||||||
| City: | LA PUENTE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917445111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6268108222 | ||||||||
| FaxNumber: | 6269651337 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2006 | ||||||||
| LastUpdateDate: | 02/02/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 40804 | CA | Y | Dental Providers | Dentist |
No ID Information.