Provider Demographics
NPI:1174710552
Name:ELMIRA ABRAAMYAN DDS
Entity type:Organization
Organization Name:ELMIRA ABRAAMYAN DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ELMIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAAMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-331-7000
Mailing Address - Street 1:6137 WATT AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:NORTH HIGHLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:95660
Mailing Address - Country:US
Mailing Address - Phone:916-331-7000
Mailing Address - Fax:916-331-7007
Practice Address - Street 1:6137 WATT AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:NORTH HIGHLANDS
Practice Address - State:CA
Practice Address - Zip Code:95660
Practice Address - Country:US
Practice Address - Phone:916-331-7000
Practice Address - Fax:916-331-7007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA422631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty