Provider Demographics
NPI:1225513583
Name:AMANDA RAFI, DMD APDC
Entity Type:Organization
Organization Name:AMANDA RAFI, DMD APDC
Other - Org Name:RAFI DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:480-510-8888
Mailing Address - Street 1:14591 NEWPORT AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6026
Mailing Address - Country:US
Mailing Address - Phone:949-771-7234
Mailing Address - Fax:
Practice Address - Street 1:14591 NEWPORT AVE STE 108
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6026
Practice Address - Country:US
Practice Address - Phone:480-510-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-02
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Multi-Specialty