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General NPI Number Information
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NPI Number | 1174220503
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Entity Type | Individual
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Provider Name | ARMENAK SHAHNAZARYAN
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Gender | Male
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Dates
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Enumeration Date | 02/15/2023
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 407 E FIRST ST
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City | SANTA ANA
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State | CA
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Zip | 92701
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Country | US
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Telephone | 714-541-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 3330 E FOOTHILL BLVD UNIT 335
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City | PASADENA
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State | CA
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Zip | 91107-3895
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Country | US
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Telephone | 818-687-4445
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 108603
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License Number State | CA
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