Provider Demographics
NPI:1619099033
Name:JIRAIR GASPARIAN DDS INC.
Entity Type:Organization
Organization Name:JIRAIR GASPARIAN DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIRAIR
Authorized Official - Middle Name:
Authorized Official - Last Name:GASPARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-874-5855
Mailing Address - Street 1:3535 CAHUENGA BLVD W
Mailing Address - Street 2:SUITE 115
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90068-1353
Mailing Address - Country:US
Mailing Address - Phone:323-874-5855
Mailing Address - Fax:323-874-5820
Practice Address - Street 1:3535 CAHUENGA BLVD W
Practice Address - Street 2:SUITE 115
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-1353
Practice Address - Country:US
Practice Address - Phone:323-874-5855
Practice Address - Fax:323-874-5820
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JIRAIR GASPARIAN DDS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-05
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA448811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty