Provider Demographics
NPI:1598881831
Name:KERENDIAN PARTIYELI, BITA
Entity Type:Individual
Prefix:
First Name:BITA
Middle Name:
Last Name:KERENDIAN PARTIYELI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 N ELM DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-3420
Mailing Address - Country:US
Mailing Address - Phone:310-770-6002
Mailing Address - Fax:
Practice Address - Street 1:9810 SIERRA AVE STE D
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-6779
Practice Address - Country:US
Practice Address - Phone:909-429-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA444991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice