| Mirzoyan Dental Corporation | |
|
1127 N Pacific Ave Glendale CA 91202-2358 | |
| (818) 551-1127 | |
| (818) 551-1167 |
| Full Name | Mirzoyan Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 1127 N Pacific Ave, Glendale, California |
| Authorized Official Name and Position | Lilit Mirzoyan (CEO) |
| Authorized Official Contact | 8185511127 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mirzoyan Dental Corporation 1127 N Pacific Ave Glendale CA 91202-2358 Ph: (818) 551-1127 | Mirzoyan Dental Corporation 1127 N Pacific Ave Glendale CA 91202-2358 Ph: (818) 551-1127 |
| NPI Number | 1952675977 |
|---|---|
| Provider Enumeration Date | 03/08/2012 |
| Last Update Date | 03/08/2012 |
| Medicare PECOS PAC ID | 8527223718 |
|---|---|
| Medicare Enrollment ID | O20120713000581 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952675977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 59938 (California) | Primary |
| Provider Name | Lilit Mirzoyan |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1275834871 PECOS PAC ID: 9436314622 Enrollment ID: I20120713000585 |
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