Provider Demographics
NPI:1073889721
Name:KESHISHIAN, ARBI
Entity Type:Individual
Prefix:
First Name:ARBI
Middle Name:
Last Name:KESHISHIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 E. ANGELENO AVE STE# 106
Mailing Address - Street 2:421 E. ANGELENO AVE STE# 106
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91501
Mailing Address - Country:US
Mailing Address - Phone:818-409-0924
Mailing Address - Fax:818-409-0902
Practice Address - Street 1:421 E. ANGELENO AVE STE# 106
Practice Address - Street 2:421 E. ANGELENO AVE STE# 106
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91501
Practice Address - Country:US
Practice Address - Phone:818-409-0924
Practice Address - Fax:818-409-0902
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA615341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice