Provider Demographics
NPI:1831478908
Name:SARKISSIAN, CHRISTINE
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:SARKISSIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W GLENOAKS BLVD
Mailing Address - Street 2:104
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 W GLENOAKS BLVD
Practice Address - Street 2:104
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202
Practice Address - Country:US
Practice Address - Phone:818-653-2322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP363124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist