Provider Demographics
NPI:1467444737
Name:HALAJIAN, VATCHE (DDS)
Entity Type:Individual
Prefix:DR
First Name:VATCHE
Middle Name:
Last Name:HALAJIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:VIC
Other - Middle Name:ARTHUR
Other - Last Name:HALAJIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:230 N MARYLAND AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4282
Mailing Address - Country:US
Mailing Address - Phone:818-502-9990
Mailing Address - Fax:
Practice Address - Street 1:230 N MARYLAND AVE STE 205
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4282
Practice Address - Country:US
Practice Address - Phone:818-502-9990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38192122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist