Provider Demographics
NPI:1609284363
Name:ARPIN V. KHOSTEGYAN DDS
Entity Type:Organization
Organization Name:ARPIN V. KHOSTEGYAN DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARPIN
Authorized Official - Middle Name:VERONICA
Authorized Official - Last Name:KHOSTEGYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-298-4556
Mailing Address - Street 1:4448 ELLENITA AVE
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4928
Mailing Address - Country:US
Mailing Address - Phone:818-298-4556
Mailing Address - Fax:
Practice Address - Street 1:2200 W OLIVE AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2626
Practice Address - Country:US
Practice Address - Phone:818-298-4556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61819261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental