Provider Demographics
NPI:1639340920
Name:SARGISSIAN, VICTOR (DDS)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:
Last Name:SARGISSIAN
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 1:3922 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3637
Mailing Address - Country:US
Mailing Address - Phone:805-654-0880
Mailing Address - Fax:805-654-7006
Practice Address - Street 1:3922 TELEGRAPH ROAD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1810
Practice Address - Country:US
Practice Address - Phone:805-654-0880
Practice Address - Fax:805-654-7006
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA438541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice