Provider Demographics
NPI:1699345934
Name:ASATRYAN & BAKHTAMIAN DENTAL CORP
Entity type:Organization
Organization Name:ASATRYAN & BAKHTAMIAN DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ALEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKHTAMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-248-9988
Mailing Address - Street 1:2644 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-3510
Mailing Address - Country:US
Mailing Address - Phone:818-248-9988
Mailing Address - Fax:818-248-0081
Practice Address - Street 1:2644 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-3510
Practice Address - Country:US
Practice Address - Phone:818-248-9988
Practice Address - Fax:818-248-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty