Provider Demographics
NPI:1114418704
Name:AKOPYAN, NAREK (DMD)
Entity Type:Individual
Prefix:
First Name:NAREK
Middle Name:
Last Name:AKOPYAN
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 1:3340 RINCONADA BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-7194
Mailing Address - Country:US
Mailing Address - Phone:575-382-2054
Mailing Address - Fax:575-382-4320
Practice Address - Street 1:2220 FOOTHILL BLVD STE A
Practice Address - Street 2:
Practice Address - City:LA CANADA FLINTRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91011-1413
Practice Address - Country:US
Practice Address - Phone:818-248-1021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-20
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD49821223G0001X
NMTD-00-110390200000X
CADDS1076361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program