Provider Demographics
NPI:1467237529
Name:BAROUIR DEIRMENJIAN DENTAL CORPORATION
Entity Type:Organization
Organization Name:BAROUIR DEIRMENJIAN DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BAROUIR
Authorized Official - Middle Name:ARSHAG
Authorized Official - Last Name:DEIRMENJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:103-497-2211
Mailing Address - Street 1:15500 W SAND ST STE 6
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-2931
Mailing Address - Country:US
Mailing Address - Phone:760-241-3336
Mailing Address - Fax:
Practice Address - Street 1:12363 LIMONITE AVE STE 960
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:91752-3689
Practice Address - Country:US
Practice Address - Phone:951-360-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty