Provider Demographics
NPI:1629109699
Name:ARAKELIAN, SCARLET ABNOUS (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCARLET
Middle Name:ABNOUS
Last Name:ARAKELIAN
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 1:18911 CROCHERON AVE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-2363
Mailing Address - Country:US
Mailing Address - Phone:718-460-3433
Mailing Address - Fax:718-460-3435
Practice Address - Street 1:18911 CROCHERON AVE
Practice Address - Street 2:SUITE 1B
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-2363
Practice Address - Country:US
Practice Address - Phone:718-460-3433
Practice Address - Fax:718-460-3435
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0493081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02367944Medicaid