Provider Demographics
NPI:1235507393
Name:PILIKYAN, ANI
Entity Type:Individual
Prefix:DR
First Name:ANI
Middle Name:
Last Name:PILIKYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 CLEVELAND RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-1011
Mailing Address - Country:US
Mailing Address - Phone:818-720-6691
Mailing Address - Fax:
Practice Address - Street 1:1715 CLEVELAND RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-1011
Practice Address - Country:US
Practice Address - Phone:818-720-6691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-07
Last Update Date:2015-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65082122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist