Provider Demographics
NPI:1649658204
Name:HAMLET KARAPETIAN DENTAL CORP.
Entity type:Organization
Organization Name:HAMLET KARAPETIAN DENTAL CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMLET
Authorized Official - Middle Name:
Authorized Official - Last Name:KARAPETIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:805-928-6776
Mailing Address - Street 1:1338 SANTA ROSA RD
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401
Mailing Address - Country:US
Mailing Address - Phone:805-543-8440
Mailing Address - Fax:805-928-6788
Practice Address - Street 1:201 N COLLEGE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454
Practice Address - Country:US
Practice Address - Phone:805-925-6039
Practice Address - Fax:805-928-6788
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRIENDLY SMILES DENTAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-14
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA532281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA53228OtherDENTIST