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General NPI Number Information
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NPI Number | 1851948061
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Entity Type | Organization
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Legal Business Name | HAMLET KHACHATRYAN DDS, INC.
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 1698 CRUICKSHANK DRIVE SUITE B
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City | EL CENTRO
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State | CA
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Zip | 92243
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Country | US
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Telephone | 760-970-8754
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Fax |
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Provider Business Mailing Address
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Address Line | 2022 ROSITA AVE
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City | BURBANK
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State | CA
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Zip | 91504-2821
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Country | US
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Telephone | 818-300-5849
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. HAMLET KHACHATRYAN
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Credential | DDS
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Telephone | 818-300-5849
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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