Provider Demographics
NPI:1164179032
Name:NAZITA RADBAKHT GAFF INC.
Entity Type:Organization
Organization Name:NAZITA RADBAKHT GAFF INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAZITA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-290-6832
Mailing Address - Street 1:1419 SUPERIOR AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-2723
Mailing Address - Country:US
Mailing Address - Phone:949-646-4300
Mailing Address - Fax:949-688-0002
Practice Address - Street 1:1419 SUPERIOR AVE STE 6
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-2723
Practice Address - Country:US
Practice Address - Phone:949-646-4300
Practice Address - Fax:949-688-0002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-09
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty