Provider Demographics
NPI:1124387501
Name:VARTANIAN, ARLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARLEN
Middle Name:
Last Name:VARTANIAN
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 1:218 LOUISE LN
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-3351
Mailing Address - Country:US
Mailing Address - Phone:650-270-8990
Mailing Address - Fax:
Practice Address - Street 1:218 LOUISE LN
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-3351
Practice Address - Country:US
Practice Address - Phone:650-270-8990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-07
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62865122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist