Provider Demographics
NPI:1083925663
Name:ARZAMENDIA, ARIEL A (DMD)
Entity Type:Individual
Prefix:DR
First Name:ARIEL
Middle Name:A
Last Name:ARZAMENDIA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 112TH ST SW
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-4875
Mailing Address - Country:US
Mailing Address - Phone:860-578-5619
Mailing Address - Fax:
Practice Address - Street 1:1019 112TH ST SW
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-4875
Practice Address - Country:US
Practice Address - Phone:425-551-6001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60332158122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist