Provider Demographics
NPI:1811166192
Name:OZBARDAKCI, JOHN (DDS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:OZBARDAKCI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:CAN
Other - Middle Name:
Other - Last Name:OZBARDAKCI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3917 LOS OLIVOS LN.
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-1629
Mailing Address - Country:US
Mailing Address - Phone:818-515-7346
Mailing Address - Fax:818-557-8749
Practice Address - Street 1:1319 N. SAN FERNANDO BLVD.
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-4236
Practice Address - Country:US
Practice Address - Phone:818-557-2299
Practice Address - Fax:818-557-8749
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31143122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist