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General NPI Number Information
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NPI Number | 1356465009
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Entity Type | Organization
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Legal Business Name | FARZAD SHAYGAN DDS MS INC
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 03/07/2019
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Provider Practice Location Address
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Address Line | 4040 BARRANCA PRKY #140
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City | IRVINE
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State | CA
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Zip | 92604
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Country | US
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Telephone | 949-559-7300
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Fax | 949-552-2719
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Provider Business Mailing Address
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Address Line | 4040 BARRANCA PRKY #140
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City | IRVINE
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State | CA
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Zip | 92604
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Country | US
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Telephone | 949-559-7300
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Fax | 949-552-2719
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Authorized Official
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Title or Position | CEO
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Name | FARZAD SHAYGAN
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Credential | D.D.S, M.S
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Telephone | 949-559-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 37018
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License Number State | CA
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