Provider Demographics
NPI:1710023056
Name:ARTMAN, GEORGE Y
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:Y
Last Name:ARTMAN
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 1:18940 OLYMPIA ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91326-3022
Mailing Address - Country:US
Mailing Address - Phone:323-751-4100
Mailing Address - Fax:714-571-3560
Practice Address - Street 1:355 W MANCHESTER AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-3327
Practice Address - Country:US
Practice Address - Phone:323-751-4100
Practice Address - Fax:323-751-2853
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48223122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD48223Medicaid