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Organization
MGDVELADZE DDS INC.
Active
Organization
MGDVELADZE DDS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMILIIA MGDVELADZE DDS (CHIEF EXECUTIVE OFFICER)
(424) 216-0718
Entity
Organization
Contact information
Practice address
5710 W 83RD ST, LOS ANGELES, CA 90045-4301
(424) 216-0718
Mailing address
5710 W 83RD ST, LOS ANGELES, CA 90045-4301
(424) 216-0718
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/20/2026
Last updated
05/20/2026
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