Healthcare Provider Details

I. General information

NPI: 1629147038
Provider Name (Legal Business Name): ARAXIE YETENEKIAN-GETTAS D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2028 W PICO BLVD
LOS ANGELES CA
90006-5011
US

IV. Provider business mailing address

2028 W PICO BLVD
LOS ANGELES CA
90006-5011
US

V. Phone/Fax

Practice location:
  • Phone: 213-380-5506
  • Fax: 213-380-0754
Mailing address:
  • Phone: 213-380-5506
  • Fax: 213-380-0754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number35186
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: