Provider Demographics
NPI:1386411361
Name:LUCY HALLAJIAN DDS INC
Entity type:Organization
Organization Name:LUCY HALLAJIAN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLAJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-389-6893
Mailing Address - Street 1:19500 VENTURA BLVD STE 240
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2917
Mailing Address - Country:US
Mailing Address - Phone:818-462-5303
Mailing Address - Fax:
Practice Address - Street 1:19500 VENTURA BLVD STE 240
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2917
Practice Address - Country:US
Practice Address - Phone:818-462-5303
Practice Address - Fax:818-462-5305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty