Provider Demographics
NPI:1710065719
Name:AMBARACHYAN, ARMEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARMEN
Middle Name:
Last Name:AMBARACHYAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 E ALAMEDA AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1508
Mailing Address - Country:US
Mailing Address - Phone:818-848-3026
Mailing Address - Fax:
Practice Address - Street 1:216 E ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1508
Practice Address - Country:US
Practice Address - Phone:818-848-3026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA510391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG9373901OtherDENTICAL
CA013438OtherDELTACARE USA
CAHN59910OtherSAFEGUARD HMO
CA22750OtherPACIFICARE
CA203213901OtherPPO INSURANCES
CA239118OtherCIGNA
CA1815321OtherUCCI