Provider Demographics
NPI:1285776245
Name:PETROSYAN, ARMAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ARMAN
Middle Name:
Last Name:PETROSYAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 W LEXINGTON DR UNIT D
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2754
Mailing Address - Country:US
Mailing Address - Phone:213-448-1779
Mailing Address - Fax:
Practice Address - Street 1:1009 GLENOAKS BLVD
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-1436
Practice Address - Country:US
Practice Address - Phone:818-361-3889
Practice Address - Fax:818-361-6280
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA511291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice