Provider Demographics
NPI:1225548035
Name:DEMIRCHYAN, ASTGIK AMY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ASTGIK
Middle Name:AMY
Last Name:DEMIRCHYAN
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 1:10455 GLORY AVE
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-2025
Mailing Address - Country:US
Mailing Address - Phone:818-395-8133
Mailing Address - Fax:
Practice Address - Street 1:7738 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-2121
Practice Address - Country:US
Practice Address - Phone:818-352-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101854122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist