Provider Demographics
NPI:1851940126
Name:BARAKAZYAN, ARTUR (DDS)
Entity Type:Individual
Prefix:
First Name:ARTUR
Middle Name:
Last Name:BARAKAZYAN
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 1:529 W CALIFORNIA AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-4100
Mailing Address - Country:US
Mailing Address - Phone:916-505-8254
Mailing Address - Fax:
Practice Address - Street 1:1565 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-4233
Practice Address - Country:US
Practice Address - Phone:323-529-9053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1044041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice