Provider Demographics
NPI:1003289539
Name:DR.ARIA IRVANI, DDS INC.
Entity Type:Organization
Organization Name:DR.ARIA IRVANI, DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:IRVANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-458-5858
Mailing Address - Street 1:26700 TOWNE CENTRE DR
Mailing Address - Street 2:210
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2844
Mailing Address - Country:US
Mailing Address - Phone:949-458-5858
Mailing Address - Fax:949-458-7714
Practice Address - Street 1:26700 TOWNE CENTRE DR
Practice Address - Street 2:210
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2844
Practice Address - Country:US
Practice Address - Phone:949-458-5858
Practice Address - Fax:949-458-7714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty