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General NPI Number Information
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NPI Number | 1386088656
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Entity Type | Organization
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Legal Business Name | CHARLES ZAHEDI DENTAL CORPORATION
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Dates
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Enumeration Date | 04/17/2013
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Last Update Date | 04/14/2017
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Provider Practice Location Address
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Address Line | 4221 MACARTHUR BLVD SUITE B3
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City | NEWPORT BEACH
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State | CA
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Zip | 92660
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Country | US
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Telephone | 855-996-3872
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Fax | 888-872-5556
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Provider Business Mailing Address
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Address Line | 4590 MACARTHUR BLVD SUITE 500
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2028
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Country | US
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Telephone | 855-996-3872
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Fax | 888-872-5556
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Authorized Official
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Title or Position | CEO
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Name | MR. CHARLES S ZAHEDI
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Credential | DDS
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Telephone | 949-922-4450
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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 | 56825
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License Number State | CA
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