# V A HALAJIAN DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dental Specialty Group of Glendale
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104254374
- **Authorized official:** DR. VIC HALAJIAN (PRESIDENT)
- **Authorized official phone:** (818) 416-4776

## Contact information

- **Practice address:** 230 N MARYLAND AVE, SUITE 206, GLENDALE, CA 91206-4261
- **Practice address phone:** (818) 547-2804
- **Practice address fax:** (818) 502-1197
- **Mailing address:** 230 N MARYLAND AVE, SUITE 206, GLENDALE, CA 91206-4261
- **Mailing address phone:** (818) 547-2804
- **Mailing address fax:** (818) 502-1197

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 56717 | CA | Yes |
| 1223P0221X | Pediatric Dentistry | 58380 | CA | — |
| 1223P0300X | Periodontics | 30624 | CA | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 55829 | CA | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | 57793 | CA | — |

## Other

- **Enumeration date:** 10/24/2013
- **Last updated:** 10/24/2013