# WESTERNOFF DMD MD & MARDIROSIAN DDS MD GP-W

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710556550
- **Authorized official:** MARTIN MARDIROSIAN DDS, MS, MD (ORAL SURGEON)
- **Authorized official phone:** (310) 375-0514

## Contact information

- **Practice address:** 8540 S SEPULVEDA BLVD STE 1206, LOS ANGELES, CA 90045-3819
- **Practice address phone:** (310) 375-0514
- **Mailing address:** 1706 S ELENA AVE STE A, REDONDO BEACH, CA 90277-5715
- **Mailing address phone:** (310) 375-0514

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 06/24/2021
- **Last updated:** 06/24/2021