Provider Demographics
NPI:1083338818
Name:MOURADIAN DMD & KIRIKIAN DDS, A PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:MOURADIAN DMD & KIRIKIAN DDS, A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:KIDS DENTAL AVENUE, DENTAL OFFICE OF DRS. MOURADIAN & KIRIKIAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOURADIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:323-807-2527
Mailing Address - Street 1:701 N BRAND BLVD STE 820
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-1283
Mailing Address - Country:US
Mailing Address - Phone:323-807-2527
Mailing Address - Fax:
Practice Address - Street 1:4787 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-2631
Practice Address - Country:US
Practice Address - Phone:323-807-2527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty