=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336067842
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GHOWSI DENTAL CORP.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2026
-----------------------------------------------------
Last Update Date | 07/10/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 27620 MARGUERITE PKWY STE D
-----------------------------------------------------
City | MISSION VIEJO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92692-3607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-220-4622
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 27620 MARGUERITE PKWY STE D
-----------------------------------------------------
City | MISSION VIEJO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92692-3607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CEO
-----------------------------------------------------
Name | ALI GHOWSI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 408-220-4622
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223X0400X
-----------------------------------------------------
Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------