Provider Demographics
NPI:1629214341
Name:BARSAMIAN, SEZA T (DDS)
Entity type:Individual
Prefix:DR
First Name:SEZA
Middle Name:T
Last Name:BARSAMIAN
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 1:4022 KATELLA AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3400
Mailing Address - Country:US
Mailing Address - Phone:562-596-4439
Mailing Address - Fax:462-596-4799
Practice Address - Street 1:4022 KATELLA AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3400
Practice Address - Country:US
Practice Address - Phone:562-596-4439
Practice Address - Fax:462-596-4799
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-30
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54767122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist