Provider Demographics
NPI:1093957532
Name:TERMECHI, GISOO (DDS)
Entity Type:Individual
Prefix:
First Name:GISOO
Middle Name:
Last Name:TERMECHI
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 1:406 N PALM DR
Mailing Address - Street 2:APT# 102
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4053
Mailing Address - Country:US
Mailing Address - Phone:310-431-8601
Mailing Address - Fax:
Practice Address - Street 1:929 N ORANGE GROVE BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-3354
Practice Address - Country:US
Practice Address - Phone:626-449-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58161122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist