Provider Demographics
NPI:1073263901
Name:PARSHAN NAMIRANIAN, DDS, PC
Entity Type:Organization
Organization Name:PARSHAN NAMIRANIAN, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PARSHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAMIRANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-334-4880
Mailing Address - Street 1:3209 DEMARTINI DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-2524
Mailing Address - Country:US
Mailing Address - Phone:408-334-4880
Mailing Address - Fax:
Practice Address - Street 1:25982 PALA STE 110
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6724
Practice Address - Country:US
Practice Address - Phone:408-334-4880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty