Provider Demographics
NPI:1225097215
Name:DEIRMENJIAN, BAROUIR ARSHAG
Entity Type:Individual
Prefix:DR
First Name:BAROUIR
Middle Name:ARSHAG
Last Name:DEIRMENJIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15643 SHERMAN WAY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-7652
Mailing Address - Country:US
Mailing Address - Phone:855-705-3434
Mailing Address - Fax:
Practice Address - Street 1:15448 E AMAR RD
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91744-5111
Practice Address - Country:US
Practice Address - Phone:626-810-8222
Practice Address - Fax:626-965-1337
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40804122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist