Provider Demographics
NPI:1477653368
Name:ZHITNITSKY, JULIAN HENRY (DDS)
Entity Type:Individual
Prefix:MR
First Name:JULIAN
Middle Name:HENRY
Last Name:ZHITNITSKY
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 1:7220 WOODMAN AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405
Mailing Address - Country:US
Mailing Address - Phone:818-785-8388
Mailing Address - Fax:818-785-5514
Practice Address - Street 1:7220 WOODMAN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405
Practice Address - Country:US
Practice Address - Phone:818-785-8388
Practice Address - Fax:818-785-5514
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA403291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG92011Medicaid