Provider Demographics
NPI:1467018648
Name:IMAN MALEK HEDAYAT DDS INC
Entity Type:Organization
Organization Name:IMAN MALEK HEDAYAT DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MALEK HEDAYAT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-292-2091
Mailing Address - Street 1:213 NATIVE SPG
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-1197
Mailing Address - Country:US
Mailing Address - Phone:949-292-2091
Mailing Address - Fax:
Practice Address - Street 1:3755 S PLAZA DR
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-7463
Practice Address - Country:US
Practice Address - Phone:657-212-5324
Practice Address - Fax:657-212-5322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-14
Last Update Date:2023-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental