Provider Demographics
NPI:1538475454
Name:YERMIAN, NADER (DDS)
Entity Type:Individual
Prefix:DR
First Name:NADER
Middle Name:
Last Name:YERMIAN
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 1:11711 OHIO AVE APT 116
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-2268
Mailing Address - Country:US
Mailing Address - Phone:858-414-4131
Mailing Address - Fax:
Practice Address - Street 1:1950 SAWTELLE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-7074
Practice Address - Country:US
Practice Address - Phone:310-312-0882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA597521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice