Provider Demographics
NPI:1205653417
Name:ARKELAKYAN GYOKCHYAN & KHACHATRYAN DENTAL INC
Entity type:Organization
Organization Name:ARKELAKYAN GYOKCHYAN & KHACHATRYAN DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:KHACHATRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-601-8550
Mailing Address - Street 1:11628 AMESTOY AVE
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-2526
Mailing Address - Country:US
Mailing Address - Phone:818-601-8550
Mailing Address - Fax:
Practice Address - Street 1:9275 BASE LINE RD
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-1203
Practice Address - Country:US
Practice Address - Phone:909-490-5576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty