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General NPI Number Information
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NPI Number | 1356865422
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Entity Type | Organization
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Legal Business Name | F.FARSHIDI DDS MD INC
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 17452 IRVINE BLVD STE 100
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City | TUSTIN
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State | CA
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Zip | 92780-3031
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Country | US
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Telephone | 714-838-4141
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Fax |
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Provider Business Mailing Address
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Address Line | 17452 IRVINE BLVD STE 100
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City | TUSTIN
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State | CA
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Zip | 92780-3031
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Country | US
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Telephone | 714-838-4141
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FARZIN FARSHIDI
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Credential | DDS MD
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Telephone | 714-838-4141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number | DDS63573
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License Number State | CA
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