Provider Demographics
NPI:1336876580
Name:SARGSYAN, ARSHAK (DDS)
Entity Type:Individual
Prefix:
First Name:ARSHAK
Middle Name:
Last Name:SARGSYAN
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 1:710 S CENTRAL AVE STE 320
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-4612
Mailing Address - Country:US
Mailing Address - Phone:818-484-8084
Mailing Address - Fax:818-484-7877
Practice Address - Street 1:710 S CENTRAL AVE STE 320
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-4612
Practice Address - Country:US
Practice Address - Phone:818-484-8084
Practice Address - Fax:818-484-7877
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1077411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice