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
Phone: (818) 709-0090
Fax: (818) 709-6002
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255534293 | NPPES |
| Other | D42430 | DENTI CAL TREATING PROVID |
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