Provider Demographics
NPI:1417923624
Name:NAZARIAN, ARA (DENTIST)
Entity Type:Individual
Prefix:DR
First Name:ARA
Middle Name:
Last Name:NAZARIAN
Suffix:
Gender:M
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48950 VAN DYKE AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-2567
Mailing Address - Country:US
Mailing Address - Phone:248-457-0500
Mailing Address - Fax:248-457-0501
Practice Address - Street 1:48950 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48317-2567
Practice Address - Country:US
Practice Address - Phone:482-457-0500
Practice Address - Fax:248-457-0501
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010168911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice