Provider Demographics
NPI:1912008889
Name:ADAMIAN, JOSEPH
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:ADAMIAN
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 1:206 N JACKSON ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4330
Mailing Address - Country:US
Mailing Address - Phone:818-500-1735
Mailing Address - Fax:818-500-0434
Practice Address - Street 1:206 N JACKSON ST
Practice Address - Street 2:SUITE 302
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4330
Practice Address - Country:US
Practice Address - Phone:818-500-1735
Practice Address - Fax:818-500-0434
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA461611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice