Provider Demographics
NPI:1831316629
Name:BARSEGHIAN, ALBERT (DDS)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:
Last Name:BARSEGHIAN
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 1:2205 E PALMDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-1316
Mailing Address - Country:US
Mailing Address - Phone:661-273-1333
Mailing Address - Fax:661-273-1687
Practice Address - Street 1:2205 E PALMDALE BLVD
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-1316
Practice Address - Country:US
Practice Address - Phone:661-273-1333
Practice Address - Fax:661-273-1687
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA547781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA54778OtherDENTIST