Provider Demographics
NPI:1124196217
Name:KREKORIANS, VANIK (DDS)
Entity Type:Individual
Prefix:DR
First Name:VANIK
Middle Name:
Last Name:KREKORIANS
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 1:9865 TUJUNGA CANYON PL
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-2910
Mailing Address - Country:US
Mailing Address - Phone:818-352-7304
Mailing Address - Fax:
Practice Address - Street 1:6900 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-2713
Practice Address - Country:US
Practice Address - Phone:818-353-9595
Practice Address - Fax:818-353-0505
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2011-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52074122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist