Provider Demographics
NPI:1659987857
Name:TOPDJIAN, TERESA DIANE (RDH)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:DIANE
Last Name:TOPDJIAN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 S WILTON PL APT 104
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-4589
Mailing Address - Country:US
Mailing Address - Phone:206-354-1212
Mailing Address - Fax:
Practice Address - Street 1:346 S WILTON PL APT 104
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-4589
Practice Address - Country:US
Practice Address - Phone:206-354-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist