Provider Demographics
NPI:1912110347
Name:YEDIGARIAN, ROUBEN A (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROUBEN
Middle Name:A
Last Name:YEDIGARIAN
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 1:8371B GREENSBORO DR
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-3529
Mailing Address - Country:US
Mailing Address - Phone:703-821-0882
Mailing Address - Fax:
Practice Address - Street 1:8371B GREENSBORO DR
Practice Address - Street 2:
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-3529
Practice Address - Country:US
Practice Address - Phone:703-821-0882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401005564122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist