Provider Demographics
NPI:1518333962
Name:HAGHANI, SOHA (DDS)
Entity Type:Individual
Prefix:
First Name:SOHA
Middle Name:
Last Name:HAGHANI
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 1:26741 PORTOLA PKWY STE 1D
Mailing Address - Street 2:
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-1762
Mailing Address - Country:US
Mailing Address - Phone:310-873-8353
Mailing Address - Fax:
Practice Address - Street 1:26741 PORTOLA PKWY STE 1D
Practice Address - Street 2:
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-1762
Practice Address - Country:US
Practice Address - Phone:310-873-8353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64876122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist