Provider Demographics
NPI:1376609032
Name:ARAXIE YETENEKIAN-GETTAS, D.M.D., INC.
Entity Type:Organization
Organization Name:ARAXIE YETENEKIAN-GETTAS, D.M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARAXIE
Authorized Official - Middle Name:
Authorized Official - Last Name:YETENEKIAN-GETTAS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:818-246-0985
Mailing Address - Street 1:2028 W PICO BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-5011
Mailing Address - Country:US
Mailing Address - Phone:213-380-5506
Mailing Address - Fax:213-380-0754
Practice Address - Street 1:2028 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-5011
Practice Address - Country:US
Practice Address - Phone:213-380-5506
Practice Address - Fax:213-380-0754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA351861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG93782-03Medicaid