Provider Demographics
NPI:1255349197
Name:VLADIMIR EYCHIS DDS INC
Entity type:Organization
Organization Name:VLADIMIR EYCHIS DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:I
Authorized Official - Last Name:EYCHIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-874-0110
Mailing Address - Street 1:7260 SUNSET BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:LA
Mailing Address - State:CA
Mailing Address - Zip Code:90046
Mailing Address - Country:US
Mailing Address - Phone:323-874-0110
Mailing Address - Fax:323-874-4710
Practice Address - Street 1:7260 SUNSET BLVD
Practice Address - Street 2:STE 201
Practice Address - City:LA
Practice Address - State:CA
Practice Address - Zip Code:90046
Practice Address - Country:US
Practice Address - Phone:323-874-0110
Practice Address - Fax:323-874-4710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30202122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB3020202Medicaid