Provider Demographics
NPI:1962541292
Name:KHACHATRIAN, ARTOUR IV (DDS)
Entity type:Individual
Prefix:
First Name:ARTOUR
Middle Name:
Last Name:KHACHATRIAN
Suffix:IV
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 1:7063 W SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7509
Mailing Address - Country:US
Mailing Address - Phone:323-962-9707
Mailing Address - Fax:323-962-9717
Practice Address - Street 1:7063 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-7509
Practice Address - Country:US
Practice Address - Phone:323-962-9707
Practice Address - Fax:323-962-9717
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA441981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice