Provider Demographics
NPI:1972930873
Name:CHRISTINE SHAHGALDIAN DDS INC
Entity Type:Organization
Organization Name:CHRISTINE SHAHGALDIAN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHGALDIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-980-9090
Mailing Address - Street 1:2323 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-4305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2323 E 4TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-4305
Practice Address - Country:US
Practice Address - Phone:323-980-9090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTINE SHAHGALDIAN DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-09
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59269122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty