Provider Demographics
NPI:1356865422
Name:F.FARSHIDI DDS MD INC
Entity Type:Organization
Organization Name:F.FARSHIDI DDS MD INC
Other - Org Name:ORANGE COUNTY MAXILLOFACIAL SURGERY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FARZIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARSHIDI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MD
Authorized Official - Phone:714-939-7505
Mailing Address - Street 1:2401 W CHAPMAN AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-2327
Mailing Address - Country:US
Mailing Address - Phone:714-939-7505
Mailing Address - Fax:
Practice Address - Street 1:2401 W CHAPMAN AVE STE 101
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2327
Practice Address - Country:US
Practice Address - Phone:714-939-7505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-01
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS635731223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Single Specialty