Provider Demographics
NPI:1356675474
Name:MASSIH, KARMEN (DDS, MDS)
Entity Type:Individual
Prefix:DR
First Name:KARMEN
Middle Name:
Last Name:MASSIH
Suffix:
Gender:F
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 N PACIFIC AVE
Mailing Address - Street 2:STE A
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2313
Mailing Address - Country:US
Mailing Address - Phone:818-507-1515
Mailing Address - Fax:818-507-8870
Practice Address - Street 1:1017 N PACIFIC AVE
Practice Address - Street 2:STE A
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2313
Practice Address - Country:US
Practice Address - Phone:818-507-1515
Practice Address - Fax:818-507-8870
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics