Individual
DR. DMITRIY IVANOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3140 SAWTELLE BLVD APT 305, LOS ANGELES, CA 90066-1468
(310) 926-8985
Mailing address
2406 MATHEWS AVE UNIT A, REDONDO BEACH, CA 90278-5503
(310) 926-8985
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
64494
CA
1223P0300X
Periodontics
Primary
64494
CA
Other
Enumeration date
05/18/2016
Last updated
07/30/2025
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