Provider Demographics
NPI:1528189388
Name:NEW MILLENNIUM DENTAL GROUP OF ARAM ARAKELYAN
Entity Type:Organization
Organization Name:NEW MILLENNIUM DENTAL GROUP OF ARAM ARAKELYAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAKELYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-331-4538
Mailing Address - Street 1:19523 E CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-2066
Mailing Address - Country:US
Mailing Address - Phone:626-331-4538
Mailing Address - Fax:
Practice Address - Street 1:599 INLAND CENTER DR STE 110
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-1819
Practice Address - Country:US
Practice Address - Phone:909-383-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG93410-02OtherDENTICAL
CAG93410-02OtherDENTICAL