MEDICARE: SHANT AHARONIAN DENTAL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1548981574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHANT AHARONIAN DENTAL INC

Provider Business Mailing Address
First Line	:	1112 W BURBANK BLVD STE 203
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91506-1455
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1112 W BURBANK BLVD STE 203
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91506-1455
Country	:	US
Telephone Number	:	818-307-2549
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. SHANT AHARONIAN
Credential	:	DDS
Telephone Number	:	818-276-9114

Provider Enumeration Date	:	09/08/2022
Last Update Date	:	08/21/2023

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