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General NPI Number Information
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NPI Number | 1609283126
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Entity Type | Organization
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Legal Business Name | FERESHTEH KHEYRDAN , D.D.S., INC.
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Dates
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Enumeration Date | 07/16/2014
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Last Update Date | 07/16/2014
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Provider Practice Location Address
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Address Line | 3620 S BRISTOL ST SUIT # 104
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City | SANTA ANA
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State | CA
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Zip | 92704-7300
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Country | US
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Telephone | 174-662-7898
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Fax |
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Provider Business Mailing Address
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Address Line | 5405 ALTON PKWY #317
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City | IRVINE
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State | CA
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Zip | 92604-3717
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Country | US
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Telephone | 714-662-7898
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. FERESHTEH KHEYRDAN
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Credential | DDS
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Telephone | 714-662-7898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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