Provider Demographics
NPI:1548994320
Name:SAAKYAN, LUSINE (DDS)
Entity type:Individual
Prefix:
First Name:LUSINE
Middle Name:
Last Name:SAAKYAN
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 1:12633 MOORPARK ST UNIT 111
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-4539
Mailing Address - Country:US
Mailing Address - Phone:818-384-1003
Mailing Address - Fax:
Practice Address - Street 1:37134 47TH ST E
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93552-4458
Practice Address - Country:US
Practice Address - Phone:661-839-1262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1075601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice