Provider Demographics
NPI:1437374352
Name:RALPH SAHAKIAN, D.M.D., P.C.
Entity Type:Organization
Organization Name:RALPH SAHAKIAN, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WHITERELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-753-5115
Mailing Address - Street 1:14 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-5823
Mailing Address - Country:US
Mailing Address - Phone:508-753-5115
Mailing Address - Fax:508-753-6461
Practice Address - Street 1:14 LAKE AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-5823
Practice Address - Country:US
Practice Address - Phone:508-753-5115
Practice Address - Fax:508-753-6461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA169631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty