Provider Demographics
NPI:1285933119
Name:UTUDJIAN, GAREN (DDS)
Entity type:Individual
Prefix:DR
First Name:GAREN
Middle Name:
Last Name:UTUDJIAN
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 1:1921 N BUENA VISTA ST UNIT 415
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-3385
Mailing Address - Country:US
Mailing Address - Phone:818-434-6060
Mailing Address - Fax:
Practice Address - Street 1:2244 FAIR PARK AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-1910
Practice Address - Country:US
Practice Address - Phone:213-619-0619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-17
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA623621223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics