Theodorou, Larisa

Theodorou, Larisa is an individual health care provider with primary practice located at 19717 Sherman Way , Canoga Park CA 91306. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Theodorou, Larisa can be contacted via phone (818) 709-0090.

Contact Information

Primary practice address
19717 Sherman Way Canoga Park CA 91306
Fax: (818) 709-6002
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 42430 California

Profile Details

NPI number 1255534293
LBN Legal business name Theodorou, Larisa
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2007
Last updated Mar 9th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255534293 NPPES
Other D42430 DENTI CAL TREATING PROVID

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