Provider Demographics
NPI:1396884482
Name:ALEXANDARIAN, ANDREA (DMD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:ALEXANDARIAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:ALEXANDRIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:221 S OAK KNOLL AVE
Mailing Address - Street 2:#310
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-4301
Mailing Address - Country:US
Mailing Address - Phone:818-640-3102
Mailing Address - Fax:
Practice Address - Street 1:14415 CHASE ST
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-3017
Practice Address - Country:US
Practice Address - Phone:818-830-9050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA499461223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice