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General NPI Number Information
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NPI Number | 1306205430
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Entity Type | Organization
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Legal Business Name | SIAMAK VESHKINI D.M.D. A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/17/2016
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Last Update Date | 02/17/2016
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Provider Practice Location Address
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Address Line | 2207 S HARBOR BLVD
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City | ANAHEIM
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State | CA
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Zip | 92802
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Country | US
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Telephone | 714-971-7800
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Fax | 714-971-0912
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Provider Business Mailing Address
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Address Line | 2207 S HARBOR BLVD
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City | ANAHEIM
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State | CA
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Zip | 92802
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Country | US
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Telephone | 714-971-7800
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Fax | 714-971-0912
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Authorized Official
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Title or Position | CEO / OWNER
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Name | DR. SIAMAK VESHKINI
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Credential | D.M.D.
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Telephone | 714-971-7800
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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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