Provider Demographics
NPI:1558489294
Name:OMID HAROONIAN DDS INC
Entity Type:Organization
Organization Name:OMID HAROONIAN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OMID
Authorized Official - Middle Name:
Authorized Official - Last Name:HAROONIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-382-0633
Mailing Address - Street 1:1901 WESTCLIFF DR
Mailing Address - Street 2:SUITE #6
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5598
Mailing Address - Country:US
Mailing Address - Phone:310-382-0633
Mailing Address - Fax:949-646-2220
Practice Address - Street 1:1901 WESTCLIFF DR
Practice Address - Street 2:SUITE #6
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5598
Practice Address - Country:US
Practice Address - Phone:310-382-0633
Practice Address - Fax:949-646-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA541491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty