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General NPI Number Information
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NPI Number | 1972154417
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Entity Type | Organization
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Legal Business Name | FARSHAD SEYEDEIN DDS INC
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Dates
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Enumeration Date | 09/26/2019
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Last Update Date | 09/26/2019
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Provider Practice Location Address
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Address Line | 13420 NEWPORT AVE STE H
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City | TUSTIN
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State | CA
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Zip | 92780-3745
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Country | US
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Telephone | 714-852-3626
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Fax |
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Provider Business Mailing Address
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Address Line | 820 S WILDFLOWER LN
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City | ANAHEIM
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State | CA
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Zip | 92808-2300
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Country | US
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Telephone | 714-767-1353
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ENDODONTIST
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Name | FARSHAD SEYEDEIN
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Credential |
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Telephone | 714-767-1353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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