Organization
B. DEIRMENJIAN, DDS, INC.
Active
Other names
Smiles West
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BAROUIR DEIRMENJIAN DDS (CEO/PRESIDENT)
(310) 923-6981
Entity
Organization
Contact information
Practice address
12820 VICTORY BLVD, NORTH HOLLYWOOD, CA 91606-3013
(818) 792-4500
(818) 792-4501
Mailing address
260 S GLENDORA AVE STE 200, WEST COVINA, CA 91790-3041
(626) 214-1900
(626) 214-1954
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
40804
CA
1223E0200X
Endodontics
40804
CA
1223G0001X
General Practice Dentistry
40804
CA
1223P0221X
Pediatric Dentistry
40804
CA
1223P0300X
Periodontics
40804
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
40804
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
40804
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225097215
—
CA
Enumeration date
12/13/2011
Last updated
12/20/2011
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