Provider Demographics
NPI:1053504522
Name:MASOUDARAMDDS.INC
Entity Type:Organization
Organization Name:MASOUDARAMDDS.INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MASOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-838-7777
Mailing Address - Street 1:13771 NEWPORT AVE
Mailing Address - Street 2:#11
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-4693
Mailing Address - Country:US
Mailing Address - Phone:714-838-7777
Mailing Address - Fax:714-838-7777
Practice Address - Street 1:13771 NEWPORT AVE
Practice Address - Street 2:#11
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-4693
Practice Address - Country:US
Practice Address - Phone:714-838-7777
Practice Address - Fax:714-838-7777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-19
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44818122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB4481801OtherMEDICAL