MEDICARE: ARAXIE YETENEKIAN-GETTAS, D.M.D., 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	122300000X	Dentist	35186	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669691705
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARAXIE YETENEKIAN-GETTAS, D.M.D., INC.

Provider Business Mailing Address
First Line	:	5828 SANTA MONICA BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90038-2002
Country	:	US
Telephone Number	:	323-871-9191
Fax Number	:	323-871-2405

Provider Business Practice Location Address
First Line	:	5828 SANTA MONICA BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90038-2002
Country	:	US
Telephone Number	:	323-871-9191
Fax Number	:	323-871-2405

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ARAXIE YETENEKIAN-GETTAS
Credential	:	D.M.D.
Telephone Number	:	323-871-9191

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	08/22/2020

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