Provider Demographics
NPI:1053375618
Name:POPYAK, GARY MARTIN (DDS)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:MARTIN
Last Name:POPYAK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11938 PARAMOUNT BLVD
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-2306
Mailing Address - Country:US
Mailing Address - Phone:562-869-3217
Mailing Address - Fax:562-869-3217
Practice Address - Street 1:11938 PARAMOUNT BLVD
Practice Address - Street 2:SUITE 4B
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2306
Practice Address - Country:US
Practice Address - Phone:562-869-3217
Practice Address - Fax:562-869-3217
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA199551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice