| Mddds Group Inc | |
|
7317 Reseda Blvd Reseda CA 91335-8122 | |
| (818) 776-0055 | |
| (818) 776-8868 |
| Full Name | Mddds Group Inc |
|---|---|
| Speciality | Dentist |
| Location | 7317 Reseda Blvd, Reseda, California |
| Authorized Official Name and Position | Ambartsum Maytesyan (CEO) |
| Authorized Official Contact | 8187760055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mddds Group Inc 7317 Reseda Blvd Reseda CA 91335-8122 Ph: () - | Mddds Group Inc 7317 Reseda Blvd Reseda CA 91335-8122 Ph: (818) 776-0055 |
| NPI Number | 1134956717 |
|---|---|
| Provider Enumeration Date | 09/17/2024 |
| Last Update Date | 09/17/2024 |
| Medicare PECOS PAC ID | 2062946320 |
|---|---|
| Medicare Enrollment ID | O20241108000640 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134956717 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Ambartsum Maytesyan |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1972665172 PECOS PAC ID: 4587766134 Enrollment ID: I20070228000204 |
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