Provider Demographics
NPI:1679696967
Name:GASPARIAN, JIRAIR (DDS)
Entity Type:Individual
Prefix:
First Name:JIRAIR
Middle Name:
Last Name:GASPARIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 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:323-366-2125
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:323-366-2125
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA448811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice