Healthcare Provider Details

I. General information

NPI: 1003735515
Provider Name (Legal Business Name): DR. KIANA NIAZMANDI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27175 CORCUBION
MISSION VIEJO CA
92692-3207
US

IV. Provider business mailing address

27175 CORCUBION
MISSION VIEJO CA
92692-3207
US

V. Phone/Fax

Practice location:
  • Phone: 626-493-5022
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS113167
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: