Provider Demographics
NPI:1083364079
Name:SEASIDE DENTAL CARE
Entity Type:Organization
Organization Name:SEASIDE DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAJAFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-869-5754
Mailing Address - Street 1:20001 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-3738
Mailing Address - Country:US
Mailing Address - Phone:714-536-6633
Mailing Address - Fax:
Practice Address - Street 1:20001 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-3738
Practice Address - Country:US
Practice Address - Phone:714-536-6633
Practice Address - Fax:714-421-4955
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?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental