Provider Demographics
NPI:1932666369
Name:BOYAJIAN DENTAL GROUP
Entity Type:Organization
Organization Name:BOYAJIAN DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTO
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYAJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-670-6944
Mailing Address - Street 1:6206 W 87TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3902
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6206 W 87TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3902
Practice Address - Country:US
Practice Address - Phone:310-670-6944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery