Provider Demographics
NPI:1134303415
Name:AGARONIAN, ACHOT (DDS)
Entity Type:Individual
Prefix:DR
First Name:ACHOT
Middle Name:
Last Name:AGARONIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 W AVENUE K
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-5921
Mailing Address - Country:US
Mailing Address - Phone:661-942-1546
Mailing Address - Fax:661-942-6016
Practice Address - Street 1:1215 W AVENUE K
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-5921
Practice Address - Country:US
Practice Address - Phone:661-942-1546
Practice Address - Fax:661-942-6016
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-22
Last Update Date:2007-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA525761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice