Provider Demographics
NPI:1073579348
Name:HAMBARCHIAN, TEREZA (DDS)
Entity Type:Individual
Prefix:MRS
First Name:TEREZA
Middle Name:
Last Name:HAMBARCHIAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 N ORANGE ST
Mailing Address - Street 2:STE F
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2658
Mailing Address - Country:US
Mailing Address - Phone:818-241-3155
Mailing Address - Fax:818-549-0184
Practice Address - Street 1:213 N ORANGE ST STE F
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2658
Practice Address - Country:US
Practice Address - Phone:818-241-3155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA535981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA53598OtherDENTAL LICENSE