Healthcare Provider Details

I. General information

NPI: 1225489602
Provider Name (Legal Business Name): DENNIS M ARUTIAN DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2016
Last Update Date: 06/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 MARIN ST STE 190
THOUSAND OAKS CA
91360-4104
US

IV. Provider business mailing address

555 MARIN ST STE 190
THOUSAND OAKS CA
91360-4104
US

V. Phone/Fax

Practice location:
  • Phone: 805-230-1967
  • Fax: 805-230-1965
Mailing address:
  • Phone: 805-230-1967
  • Fax: 805-230-1965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number28840
License Number StateCA

VIII. Authorized Official

Name: DR. DENNIS MARK ARUTIAN
Title or Position: OWNER
Credential: DDS
Phone: 805-230-1967