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General NPI Number Information
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NPI Number | 1235477308
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Entity Type | Organization
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Legal Business Name | S VESHKINI ORTHODONTICS INC
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Dates
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Enumeration Date | 01/24/2013
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Last Update Date | 01/24/2013
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Provider Practice Location Address
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Address Line | 26902 OSO PKWY SUITE #100
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City | MISSION VIEJO
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State | CA
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Zip | 92691-5801
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Country | US
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Telephone | 949-855-2060
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Fax | 949-582-1837
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Provider Business Mailing Address
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Address Line | 26902 OSO PKWY SUITE #100
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City | MISSION VIEJO
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State | CA
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Zip | 92691-5801
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Country | US
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Telephone | 949-855-2060
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Fax | 949-582-1837
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Authorized Official
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Title or Position | OWNER
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Name | SIAMAK VESHKINI
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Credential | D.M.D.
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Telephone | 949-855-2060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 36026
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License Number State | CA
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