Provider Demographics
NPI:1225478050
Name:MICHAEL BALIKYAN,DDS.,INC
Entity Type:Organization
Organization Name:MICHAEL BALIKYAN,DDS.,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICAHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BALIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-844-6674
Mailing Address - Street 1:14912 BURBANK BLVD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-3609
Mailing Address - Country:US
Mailing Address - Phone:818-909-0222
Mailing Address - Fax:213-402-3316
Practice Address - Street 1:14912 BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91411-3609
Practice Address - Country:US
Practice Address - Phone:818-909-0222
Practice Address - Fax:213-402-3316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA529661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty