Provider Demographics
NPI:1285499947
Name:KESHISHIAN DENTAL INC A PROFESSIONAL DENTAL CORPORATION
Entity type:Organization
Organization Name:KESHISHIAN DENTAL INC A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ARBI
Authorized Official - Middle Name:
Authorized Official - Last Name:KESHISHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-751-2233
Mailing Address - Street 1:421 E ANGELENO AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91501-2286
Mailing Address - Country:US
Mailing Address - Phone:818-751-2233
Mailing Address - Fax:818-409-0902
Practice Address - Street 1:421 E ANGELENO AVE STE 106
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91501-2286
Practice Address - Country:US
Practice Address - Phone:818-751-2233
Practice Address - Fax:818-409-0902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty