Provider Demographics
NPI:1730414004
Name:ARMOND KOTIKIAN, DDS, MD, PC
Entity type:Organization
Organization Name:ARMOND KOTIKIAN, DDS, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTIKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:818-409-0924
Mailing Address - Street 1:600 W BROADWAY STE 120
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-1023
Mailing Address - Country:US
Mailing Address - Phone:818-409-0924
Mailing Address - Fax:818-409-8940
Practice Address - Street 1:600 W BROADWAY STE 120
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1023
Practice Address - Country:US
Practice Address - Phone:818-409-0924
Practice Address - Fax:818-409-8940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA495681223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty