Provider Demographics
NPI:1356549166
Name:GARABEDIAN, VIKEN LEON (DDS)
Entity type:Individual
Prefix:DR
First Name:VIKEN
Middle Name:LEON
Last Name:GARABEDIAN
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 1:30092 IVY GLENN DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-5027
Mailing Address - Country:US
Mailing Address - Phone:949-350-0507
Mailing Address - Fax:
Practice Address - Street 1:30092 IVY GLENN DR
Practice Address - Street 2:SUITE 250
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-5027
Practice Address - Country:US
Practice Address - Phone:949-350-0507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA034332122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist