Provider Demographics
NPI:1619006699
Name:MARGANIAN, VICKEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:VICKEN
Middle Name:
Last Name:MARGANIAN
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 1:2684 E COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3726
Mailing Address - Country:US
Mailing Address - Phone:626-577-5585
Mailing Address - Fax:626-577-7075
Practice Address - Street 1:2684 E COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3726
Practice Address - Country:US
Practice Address - Phone:626-577-5585
Practice Address - Fax:626-577-7075
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA438161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice