Provider Demographics
NPI:1003055377
Name:ANANIAN, ARBY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARBY
Middle Name:
Last Name:ANANIAN
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 1:847 N HOLLYWOOD WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2843
Mailing Address - Country:US
Mailing Address - Phone:818-841-5776
Mailing Address - Fax:818-841-5470
Practice Address - Street 1:847 N HOLLYWOOD WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2843
Practice Address - Country:US
Practice Address - Phone:818-248-1694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54233122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist