Provider Demographics
NPI:1114120458
Name:ARAKELIAN, MELINEHA (DDS)
Entity Type:Individual
Prefix:
First Name:MELINEHA
Middle Name:
Last Name:ARAKELIAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 N CENTRAL AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2081
Mailing Address - Country:US
Mailing Address - Phone:818-956-7137
Mailing Address - Fax:818-956-7158
Practice Address - Street 1:411 N CENTRAL AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2081
Practice Address - Country:US
Practice Address - Phone:818-956-7137
Practice Address - Fax:818-956-7158
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40204122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB4020401Medicare ID - Type Unspecified