MEDICARE: ARTUR ARKELAKYAN DDS INC

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	261QD0000X	Dental Clinic/Center	101	CA

General Provider Information

NPI Number	:	1295234607
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARTUR ARKELAKYAN DDS INC

Provider Business Mailing Address
First Line	:	905 S LAKE ST
Second Line	:	STE 102
City	:	BURBANK
State	:	CA
Zip	:	91502-2436
Country	:	US
Telephone Number	:	818-859-7979
Fax Number	:	818-859-7249

Provider Business Practice Location Address
First Line	:	905 S LAKE ST # 101102
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91502-2436
Country	:	US
Telephone Number	:	818-640-8013
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ARTUR ARKELAKYAN
Credential	:	DDS
Telephone Number	:	818-640-8013

Provider Enumeration Date	:	02/12/2018
Last Update Date	:	06/12/2019

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