Provider Demographics
NPI:1578941977
Name:SMILE WORKS, A DENTAL GROUP OF FARUKHI P.C.
Entity Type:Organization
Organization Name:SMILE WORKS, A DENTAL GROUP OF FARUKHI P.C.
Other - Org Name:NAILA R FARUKHI, A PROFESSIONAL DENTAL CORP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:SHIRAZ
Authorized Official - Last Name:HAIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-302-9124
Mailing Address - Street 1:3116 E WOODBINE RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-2090
Mailing Address - Country:US
Mailing Address - Phone:949-302-9124
Mailing Address - Fax:
Practice Address - Street 1:15018 LA MIRADA BLVD
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-4743
Practice Address - Country:US
Practice Address - Phone:714-521-6827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-18
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64017122300000X
CA578401223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty