Provider Demographics
NPI:1972863413
Name:ALTINA KARIMYAN DDS A DENTAL CORPORATION
Entity Type:Organization
Organization Name:ALTINA KARIMYAN DDS A DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KARIMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-304-3004
Mailing Address - Street 1:800 FAIRMOUNT AVE
Mailing Address - Street 2:#100
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3150
Mailing Address - Country:US
Mailing Address - Phone:626-304-3004
Mailing Address - Fax:626-304-3005
Practice Address - Street 1:800 FAIRMOUNT AVE
Practice Address - Street 2:#100
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3150
Practice Address - Country:US
Practice Address - Phone:626-304-3004
Practice Address - Fax:626-304-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA542691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty