Provider Demographics
NPI:1316375447
Name:VARTAN MARDIROSSIAN MD PLC
Entity Type:Organization
Organization Name:VARTAN MARDIROSSIAN MD PLC
Other - Org Name:MARDIROSSIAN FACIAL AESTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VARTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARDIROSSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACS
Authorized Official - Phone:703-260-8291
Mailing Address - Street 1:1401 CHAIN BRIDGE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3883
Mailing Address - Country:US
Mailing Address - Phone:703-260-8291
Mailing Address - Fax:703-691-5002
Practice Address - Street 1:1401 CHAIN BRIDGE RD STE 201
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3883
Practice Address - Country:US
Practice Address - Phone:703-260-8291
Practice Address - Fax:703-691-5002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty