Provider Demographics
NPI:1386819688
Name:MEGERDICHIAN, ARMEN SHANT (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARMEN
Middle Name:SHANT
Last Name:MEGERDICHIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22600 VENTURA BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1460
Mailing Address - Country:US
Mailing Address - Phone:818-225-9410
Mailing Address - Fax:818-225-1466
Practice Address - Street 1:22600 VENTURA BLVD STE 203
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1460
Practice Address - Country:US
Practice Address - Phone:818-225-9410
Practice Address - Fax:818-225-1466
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA393081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice