MEDICARE: ARA HARTOUNIAN DDS

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	390200000X	Student in an Organized Health Care Education/Training Program		CA

General Provider Information

NPI Number	:	1437944410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARA HARTOUNIAN DDS

Provider Business Mailing Address
First Line	:	1631 ROYAL BLVD
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91207-1557
Country	:	US
Telephone Number	:	818-284-0972
Fax Number	:

Provider Business Practice Location Address
First Line	:	1575 BLONDELL AVE STE 150
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-2661
Country	:	US
Telephone Number	:	718-405-8190
Fax Number	:

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

Provider Enumeration Date	:	04/10/2025
Last Update Date	:	04/10/2025

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