Provider Demographics
NPI:1609911361
Name:GARMESTANI, MARJAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARJAN
Middle Name:
Last Name:GARMESTANI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 TOPANGA CANYON BLVD
Mailing Address - Street 2:SUITE # 6
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-3333
Mailing Address - Country:US
Mailing Address - Phone:818-610-2007
Mailing Address - Fax:818-610-2232
Practice Address - Street 1:7300 TOPANGA CANYON BLVD
Practice Address - Street 2:SUITE # 6
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-3333
Practice Address - Country:US
Practice Address - Phone:818-610-2007
Practice Address - Fax:818-610-2232
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA458621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice