Provider Demographics
NPI:1255808614
Name:PIRIAN DENTAL GROUP PROF CORP
Entity type:Organization
Organization Name:PIRIAN DENTAL GROUP PROF CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PIRIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-435-3405
Mailing Address - Street 1:231 W VERNON AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-2778
Mailing Address - Country:US
Mailing Address - Phone:323-233-5906
Mailing Address - Fax:
Practice Address - Street 1:231 W VERNON AVE STE 107
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-2778
Practice Address - Country:US
Practice Address - Phone:323-233-5906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty