Provider Demographics
NPI:1013018787
Name:JOHN G. ADOMIAN, D.D.S., INC.
Entity Type:Organization
Organization Name:JOHN G. ADOMIAN, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GARABED
Authorized Official - Last Name:ADOMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-458-1545
Mailing Address - Street 1:919 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-1504
Mailing Address - Country:US
Mailing Address - Phone:310-458-1545
Mailing Address - Fax:310-458-1546
Practice Address - Street 1:919 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-1504
Practice Address - Country:US
Practice Address - Phone:310-458-1545
Practice Address - Fax:310-458-1546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44451122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty