Provider Demographics
NPI:1558875450
Name:LATSHIKYAN DENTAL CORPORATION
Entity Type:Organization
Organization Name:LATSHIKYAN DENTAL CORPORATION
Other - Org Name:DENTISTS OF ANAHEIM HILLS DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELMIRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LATSHIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-202-0765
Mailing Address - Street 1:PO BOX 920050
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75392-0050
Mailing Address - Country:US
Mailing Address - Phone:714-845-8500
Mailing Address - Fax:303-952-0892
Practice Address - Street 1:8162 E SANTA ANA CANYON RD SUITE 104
Practice Address - Street 2:
Practice Address - City:ANAHEIN
Practice Address - State:CA
Practice Address - Zip Code:92808
Practice Address - Country:US
Practice Address - Phone:714-202-0765
Practice Address - Fax:714-202-0765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-30
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty