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General NPI Number Information
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NPI Number | 1114164399
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Entity Type | Organization
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Legal Business Name | SAMONTE MORA NAJARAN DENTAL
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Dates
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Enumeration Date | 01/09/2009
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Last Update Date | 01/15/2009
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Provider Practice Location Address
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Address Line | 16100 SAND CANYON AVE STE 270
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City | IRVINE
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State | CA
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Zip | 92618-3725
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Country | US
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Telephone | 949-727-9077
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Fax | 949-727-9094
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Provider Business Mailing Address
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Address Line | 16100 SAND CANYON AVE STE 270
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City | IRVINE
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State | CA
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Zip | 92618-3725
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Country | US
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Telephone | 949-727-9077
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Fax | 949-727-9094
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SEPIDEH NAJARAN
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Credential | DMD
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Telephone | 949-727-9077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 50521
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 49155
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License Number State | CA
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