Provider Demographics
NPI:1689326928
Name:DADAIAN, RAFFI HRIYR (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAFFI
Middle Name:HRIYR
Last Name:DADAIAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3379 ALGINET DR
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4121
Mailing Address - Country:US
Mailing Address - Phone:818-590-9379
Mailing Address - Fax:
Practice Address - Street 1:8361 LAUREL CANYON BLVD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-3809
Practice Address - Country:US
Practice Address - Phone:818-504-9216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107257122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist