NPIMap

Organization Active NPI

Azatyan, Khacatryan, King, a Professional Dental Corporation

Doing business as Imperial Kids Dental

  • Pediatric Dentistry
  • El Centro, CA
National Provider Identifier
1659046795
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
AZATYAN, KHACATRYAN, KING, A PROFESSIONAL DENTAL CORPORATION
Doing business as
Imperial Kids Dental
Practice address
1523 W Main St Ste 108
El Centro, CA 92243-2282
Phone
(442) 283-5032
NPI assigned
Aug 11, 2021
Last updated
Nov 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Hamlet Khachatryan, DDSNPI 1720572787
Title
Owner
Phone
(818) 300-5849

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X NU Primary

Addresses

Primary practice location

1523 W Main St Ste 108
El Centro, CA 92243-2282

Mailing address

1523 W Main St Ste 108
El Centro, CA 92243-2282
Phone (760) 332-4030

Other names 1

  • Imperial Kids Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1523 W Main St
Ste 108
El Centro, CA 92243
Phone (442) 283-5032

1523 W Main St
Ste 110
El Centro, CA 92243

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636502400000",
    "number": "1659046795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 W MAIN ST STE 108",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922432282",
            "telephone_number": "760-332-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1523 W MAIN ST STE 108",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922432282",
            "telephone_number": "442-283-5032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZATYAN, KHACATRYAN, KING, A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A",
        "authorized_official_last_name": "KHACHATRYAN",
        "authorized_official_first_name": "HAMLET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-300-5849",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imperial Kids Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Imperial Kids Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Centro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.