MEDICARE: MAHIN G FARZIN, DDS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0106X	Oral and Maxillofacial Pathology Dentistry

General Provider Information

NPI Number	:	1467062224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAHIN G FARZIN, DDS INC

Provider Business Mailing Address
First Line	:	220 NEWPORT CENTER DR STE 3
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-7507
Country	:	US
Telephone Number	:	949-759-9777
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 NEWPORT CENTER DR STE 3
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-7507
Country	:	US
Telephone Number	:	949-759-9777
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MAHIN FARZIN
Credential	:	DDS
Telephone Number	:	949-759-9777

Provider Enumeration Date	:	08/06/2020
Last Update Date	:	08/06/2020

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