Provider Demographics
NPI:1083141048
Name:AVEED SAMIEE, D.D.S.
Entity Type:Organization
Organization Name:AVEED SAMIEE, D.D.S.
Other - Org Name:OC LIFETIME DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AVEED
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMIEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-215-5500
Mailing Address - Street 1:2 SATINBUSH
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1827
Mailing Address - Country:US
Mailing Address - Phone:909-967-3754
Mailing Address - Fax:
Practice Address - Street 1:25500 RANCHO NIGUEL RD STE 170
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-7373
Practice Address - Country:US
Practice Address - Phone:949-215-5500
Practice Address - Fax:949-215-0113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-21
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60760261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental