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General NPI Number Information
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NPI Number | 1023523784
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Entity Type | Organization
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Legal Business Name | TONY BEIZAEE DMD APDC
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Dates
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Enumeration Date | 12/04/2017
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 6B LIBERTY ST SUITE #155
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City | ALISO VIEJO
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State | CA
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Zip | 92656-5834
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Country | US
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Telephone | 949-362-3848
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Fax | 949-362-7540
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Provider Business Mailing Address
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Address Line | 6B LIBERTY ST SUITE #155
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City | ALISO VIEJO
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State | CA
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Zip | 92656-5834
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Country | US
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Telephone | 949-362-3848
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Fax | 949-362-7540
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Authorized Official
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Title or Position | DENTIST
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Name | TONY BEIZAEE
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Credential | DMD
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Telephone | 949-362-3848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 60128
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 53269
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 49607
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License Number State |
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Taxonomy #4
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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