Provider Demographics
NPI:1528400561
Name:MESERKHANI, ARTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARTIN
Middle Name:
Last Name:MESERKHANI
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 1:1350 MIDVALE AVE APT 401
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-6343
Mailing Address - Country:US
Mailing Address - Phone:818-489-9446
Mailing Address - Fax:
Practice Address - Street 1:1712 TAMBOR DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-2720
Practice Address - Country:US
Practice Address - Phone:818-489-9446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-18
Last Update Date:2017-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV63221223G0001X
CADDS1002291223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice