Provider Demographics
NPI:1235388778
Name:BABIAN, AVO (DDS)
Entity Type:Individual
Prefix:DR
First Name:AVO
Middle Name:
Last Name:BABIAN
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 1:13843 MILBANK ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2968
Mailing Address - Country:US
Mailing Address - Phone:818-425-7877
Mailing Address - Fax:
Practice Address - Street 1:38745 TIERRA SUBIDA AVE STE 160
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-4589
Practice Address - Country:US
Practice Address - Phone:661-272-9091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA520391223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics