Provider Demographics
NPI:1831310689
Name:ARAXIE YETENEKIAN-GETTAS, D.M.D., INC.
Entity Type:Organization
Organization Name:ARAXIE YETENEKIAN-GETTAS, D.M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARAXIE
Authorized Official - Middle Name:
Authorized Official - Last Name:YETENEKIAN-GETTAS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:818-246-0985
Mailing Address - Street 1:1224 E BROADWAY STE 101
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1408
Mailing Address - Country:US
Mailing Address - Phone:818-246-0985
Mailing Address - Fax:818-246-0296
Practice Address - Street 1:1224 E BROADWAY STE 101
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1408
Practice Address - Country:US
Practice Address - Phone:818-246-0985
Practice Address - Fax:818-246-0296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35186122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG93782-01Medicaid