Provider Demographics
NPI:1275747552
Name:FARZIN, MAHIN G (DDS)
Entity Type:Individual
Prefix:
First Name:MAHIN
Middle Name:G
Last Name:FARZIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 NEWPORT CENTER DR STE 3
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7507
Mailing Address - Country:US
Mailing Address - Phone:949-759-9777
Mailing Address - Fax:949-759-1871
Practice Address - Street 1:220 NEWPORT CENTER DR STE 3
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7507
Practice Address - Country:US
Practice Address - Phone:949-759-9777
Practice Address - Fax:949-759-1871
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA529801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice