MEDICARE: DR. ARBY ANANIAN D.D.S

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	122300000X	Dentist	54233	CA

General Provider Information

NPI Number	:	1003055377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARBY ANANIAN D.D.S

Provider Business Mailing Address
First Line	:	847 N HOLLYWOOD WAY
Second Line	:	SUITE 102
City	:	BURBANK
State	:	CA
Zip	:	91505-2843
Country	:	US
Telephone Number	:	818-841-5776
Fax Number	:	818-841-5470

Provider Business Practice Location Address
First Line	:	847 N HOLLYWOOD WAY
Second Line	:	SUITE 102
City	:	BURBANK
State	:	CA
Zip	:	91505-2843
Country	:	US
Telephone Number	:	818-248-1694
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2009
Last Update Date	:	05/24/2011

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