| NPI | 1770676967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX R SHARIFIAN Owner Dds 949-389-9195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 44540) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: CA 43860) |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 51692) | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CA 45821) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |