Provider Demographics
NPI:1780578799
Name:LILIT BAGDASARIAN DDS A PROFETIONAL CORPORATION
Entity type:Organization
Organization Name:LILIT BAGDASARIAN DDS A PROFETIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LILIT
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGDASARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-445-4286
Mailing Address - Street 1:5106 HOLLYWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6115
Mailing Address - Country:US
Mailing Address - Phone:323-667-9127
Mailing Address - Fax:
Practice Address - Street 1:5106 HOLLYWOOD BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6135
Practice Address - Country:US
Practice Address - Phone:323-667-9127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-04
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty