Provider Demographics
NPI:1790845121
Name:ARMEN AMBARACHYAN DDS INC
Entity Type:Organization
Organization Name:ARMEN AMBARACHYAN DDS INC
Other - Org Name:BURBANK-GLENDALE DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMBARACHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-848-3026
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:818-848-3082
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:818-848-3082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA510391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG93739-01OtherDENTI-CAL