Provider Demographics
NPI:1831242874
Name:ALBARIAN, ALEX ARA (DDS)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:ARA
Last Name:ALBARIAN
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 1:712 IVY ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-1004
Mailing Address - Country:US
Mailing Address - Phone:818-247-0085
Mailing Address - Fax:818-247-9166
Practice Address - Street 1:712 IVY ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1004
Practice Address - Country:US
Practice Address - Phone:818-247-0085
Practice Address - Fax:818-247-9166
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2012-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA361281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice