Provider Demographics
NPI:1235138686
Name:YARDUMIAN, ROBERT PERRY (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PERRY
Last Name:YARDUMIAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:791 KELLY RD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863
Mailing Address - Country:US
Mailing Address - Phone:719-687-9011
Mailing Address - Fax:719-687-3919
Practice Address - Street 1:791 KELLY RD
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863
Practice Address - Country:US
Practice Address - Phone:719-687-9011
Practice Address - Fax:719-687-3919
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7217122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist