Provider Demographics
NPI:1548380314
Name:ELMASSIAN, JOSEPH ALBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ALBERT
Last Name:ELMASSIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2595 E WASHINGTON BLVD
Mailing Address - Street 2:#104 STE
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107
Mailing Address - Country:US
Mailing Address - Phone:626-798-1181
Mailing Address - Fax:626-798-1236
Practice Address - Street 1:2595 E WASHINGTON BLVD
Practice Address - Street 2:#104 STE
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107
Practice Address - Country:US
Practice Address - Phone:626-798-1181
Practice Address - Fax:626-798-1236
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29044122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist