Healthcare Provider Details

I. General information

NPI: 1083744452
Provider Name (Legal Business Name): CIFARELLI, LARIJANI, SUKHANIL DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34080 GOLDEN LANTERN ST STE 201
DANA POINT CA
92629-2679
US

IV. Provider business mailing address

34080 GOLDEN LANTERN ST STE 201
DANA POINT CA
92629-2679
US

V. Phone/Fax

Practice location:
  • Phone: 949-661-5664
  • Fax: 949-661-7206
Mailing address:
  • Phone: 949-661-5664
  • Fax: 949-661-7206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateCA

VIII. Authorized Official

Name: MS. SHIRLEY SUKHANIL
Title or Position: DENTIST
Credential: DDS
Phone: 949-661-5664