Provider Demographics
NPI:1679659163
Name:SAHAKIANS, ALLEN (RDHAP, BS)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:
Last Name:SAHAKIANS
Suffix:
Gender:M
Credentials:RDHAP, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10753 MOUNTAIR AVE
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-1307
Mailing Address - Country:US
Mailing Address - Phone:818-399-1042
Mailing Address - Fax:818-293-0950
Practice Address - Street 1:10753 MOUNTAIR AVE
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-1307
Practice Address - Country:US
Practice Address - Phone:818-399-1042
Practice Address - Fax:818-293-0950
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP91124Q00000X
CA18329124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH0009101Medicaid