Provider Demographics
NPI:1427295666
Name:SARAFYAN, IRINA (DDS)
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:SARAFYAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14833 BURBANK BLVD
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-3339
Mailing Address - Country:US
Mailing Address - Phone:818-786-0888
Mailing Address - Fax:818-786-0935
Practice Address - Street 1:14833 BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-3339
Practice Address - Country:US
Practice Address - Phone:818-786-0888
Practice Address - Fax:818-786-0935
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57323122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist