Provider Demographics
NPI:1235876327
Name:SAMIRA SEINI DENTAL PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:SAMIRA SEINI DENTAL PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEINI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-390-8449
Mailing Address - Street 1:185 TRIBECA
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-0178
Mailing Address - Country:US
Mailing Address - Phone:714-390-8449
Mailing Address - Fax:714-532-1233
Practice Address - Street 1:1538 E COLLINS AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-5934
Practice Address - Country:US
Practice Address - Phone:714-532-1139
Practice Address - Fax:714-532-1233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental