Provider Demographics
NPI:1104552991
Name:AHARON HAYRAPETYAN DDS INC
Entity type:Organization
Organization Name:AHARON HAYRAPETYAN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:MR
Authorized Official - First Name:AHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYRAPETYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-745-2002
Mailing Address - Street 1:1100 E BROADWAY STE 302
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1384
Mailing Address - Country:US
Mailing Address - Phone:818-745-2002
Mailing Address - Fax:
Practice Address - Street 1:1100 E BROADWAY STE 302
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1384
Practice Address - Country:US
Practice Address - Phone:818-745-2002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1205566080OtherDDS