Healthcare Provider Details

I. General information

NPI: 1104395326
Provider Name (Legal Business Name): RASHIDI DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2018
Last Update Date: 11/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27725 SANTA MARGARITA PKWY STE 241
MISSION VIEJO CA
92691-6708
US

IV. Provider business mailing address

27725 SANTA MARGARITA PKWY STE 241
MISSION VIEJO CA
92691-6708
US

V. Phone/Fax

Practice location:
  • Phone: 949-770-8011
  • Fax:
Mailing address:
  • Phone: 949-770-8011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK MAHBOD RASHIDI
Title or Position: PRESIDENT
Credential: DDS, AEODO, MBA
Phone: 949-770-8011