Provider Demographics
NPI:1790505907
Name:EMPOWER DENTAL RANCHO-ARKELAKYAN DENTAL GROUP, INC
Entity type:Organization
Organization Name:EMPOWER DENTAL RANCHO-ARKELAKYAN DENTAL GROUP, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETART
Authorized Official - Prefix:MR
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 1:1209 N HOLLYWOOD WAY UNIT 101
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2149
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?:Yes
Parent Organization LBN:ARKELAKYAN GYOKCHYAN & KHACHATRYAN DENTAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-14
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes125K00000XDental ProvidersAdvanced Practice Dental TherapistGroup - Multi-Specialty