Provider Demographics
NPI:1184862575
Name:CHARLES S ZAHEDI DDS INC
Entity Type:Organization
Organization Name:CHARLES S ZAHEDI DDS INC
Other - Org Name:IMPLANT OUTREACH INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:S
Authorized Official - Last Name:ZAHEDI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-922-4450
Mailing Address - Street 1:4667 MACARTHUR BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1867
Mailing Address - Country:US
Mailing Address - Phone:888-871-0009
Mailing Address - Fax:888-872-5556
Practice Address - Street 1:4667 MACARTHUR BLVD STE 230
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1867
Practice Address - Country:US
Practice Address - Phone:888-871-0009
Practice Address - Fax:888-872-5556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-23
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS56825122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty