Provider Demographics
NPI:1134257975
Name:KALPAKCHIAN DMD DENTAL CORP.
Entity type:Organization
Organization Name:KALPAKCHIAN DMD DENTAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARSEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KALPAKCHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:818-503-4900
Mailing Address - Street 1:1343 DOVERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91207-1148
Mailing Address - Country:US
Mailing Address - Phone:818-507-1395
Mailing Address - Fax:818-503-4916
Practice Address - Street 1:12650 SHERMAN WAY
Practice Address - Street 2:STE. 7
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-5232
Practice Address - Country:US
Practice Address - Phone:818-503-4900
Practice Address - Fax:818-503-4916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB449041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty