Provider Demographics
NPI:1902976475
Name:VARTANIAN, JAMES N (DDS INC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:N
Last Name:VARTANIAN
Suffix:
Gender:M
Credentials:DDS INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26302 LA PAZ ROAD
Mailing Address - Street 2:SUITE # 103
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691
Mailing Address - Country:US
Mailing Address - Phone:949-586-5669
Mailing Address - Fax:949-586-5644
Practice Address - Street 1:26302 LA PAZ ROAD
Practice Address - Street 2:SUITE # 103
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-586-5669
Practice Address - Fax:949-586-5644
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA455341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice