Provider Demographics
NPI:1538313259
Name:SAHAKYAN, ASTGHIK (DDS)
Entity Type:Individual
Prefix:
First Name:ASTGHIK
Middle Name:
Last Name:SAHAKYAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6015 CARTWRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-5002
Mailing Address - Country:US
Mailing Address - Phone:818-390-4319
Mailing Address - Fax:
Practice Address - Street 1:6015 CARTWRIGHT AVE
Practice Address - Street 2:
Practice Address - City:N HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-5002
Practice Address - Country:US
Practice Address - Phone:818-390-4319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57508122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA57508Medicaid