Provider Demographics
NPI:1629093463
Name:SAAKIAN, YOURI
Entity Type:Individual
Prefix:
First Name:YOURI
Middle Name:
Last Name:SAAKIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 N PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2359
Mailing Address - Country:US
Mailing Address - Phone:818-240-0138
Mailing Address - Fax:818-240-0552
Practice Address - Street 1:1150 N PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2359
Practice Address - Country:US
Practice Address - Phone:818-240-0138
Practice Address - Fax:818-240-0552
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA424131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice