Provider Demographics
NPI:1679761050
Name:GAZARIAN, CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:GAZARIAN
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 1:12626 RIVERSIDE DR
Mailing Address - Street 2:STE 407
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3420
Mailing Address - Country:US
Mailing Address - Phone:818-980-9990
Mailing Address - Fax:818-980-9991
Practice Address - Street 1:12626 RIVERSIDE DR
Practice Address - Street 2:STE 407
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91607-3420
Practice Address - Country:US
Practice Address - Phone:818-980-9990
Practice Address - Fax:818-980-9991
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA461861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice