Provider Demographics
NPI:1780804310
Name:KARIMIAN, VARTAN (D D S)
Entity type:Individual
Prefix:DR
First Name:VARTAN
Middle Name:
Last Name:KARIMIAN
Suffix:
Gender:M
Credentials:D D S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 N PACIFIC AVE
Mailing Address - Street 2:O
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-1030
Mailing Address - Country:US
Mailing Address - Phone:818-500-0100
Mailing Address - Fax:
Practice Address - Street 1:818 N PACIFIC AVE
Practice Address - Street 2:O
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-1030
Practice Address - Country:US
Practice Address - Phone:818-500-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA383081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB-38308-01Medicare ID - Type Unspecified