Provider Demographics
NPI:1073177820
Name:ARAKELYAN PROFESSIONAL DENTAL INC
Entity Type:Organization
Organization Name:ARAKELYAN PROFESSIONAL DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAYK
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAKELYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-708-9598
Mailing Address - Street 1:617 E COLORADO ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1709
Mailing Address - Country:US
Mailing Address - Phone:323-708-9598
Mailing Address - Fax:
Practice Address - Street 1:617 E COLORADO ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1709
Practice Address - Country:US
Practice Address - Phone:323-708-9598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty