Provider Demographics
NPI:1235477308
Name:S VESHKINI ORTHODONTICS INC
Entity Type:Organization
Organization Name:S VESHKINI ORTHODONTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIAMAK
Authorized Official - Middle Name:
Authorized Official - Last Name:VESHKINI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:949-855-2060
Mailing Address - Street 1:26902 OSO PKWY
Mailing Address - Street 2:SUITE #100
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-5801
Mailing Address - Country:US
Mailing Address - Phone:949-855-2060
Mailing Address - Fax:949-582-1837
Practice Address - Street 1:26902 OSO PKWY
Practice Address - Street 2:SUITE #100
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5801
Practice Address - Country:US
Practice Address - Phone:949-855-2060
Practice Address - Fax:949-582-1837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA360261223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty