Provider Demographics
NPI:1598032054
Name:VANIK KREKORIANS DDS INC
Entity Type:Organization
Organization Name:VANIK KREKORIANS DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VANIK
Authorized Official - Middle Name:
Authorized Official - Last Name:KREKORIANS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-353-9595
Mailing Address - Street 1:9865 TUJUNGA CANYON PL
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-2910
Mailing Address - Country:US
Mailing Address - Phone:818-353-9595
Mailing Address - Fax:818-353-0505
Practice Address - Street 1:6900 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-2713
Practice Address - Country:US
Practice Address - Phone:818-353-9595
Practice Address - Fax:818-353-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA520741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty