Provider Demographics
NPI:1588046049
Name:ZAMANI, AZIN (DDS)
Entity Type:Individual
Prefix:
First Name:AZIN
Middle Name:
Last Name:ZAMANI
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 1:60 ORANGE BLOSSOM
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618
Mailing Address - Country:US
Mailing Address - Phone:210-289-1699
Mailing Address - Fax:
Practice Address - Street 1:27901 LA PAZ RD STE D
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-3932
Practice Address - Country:US
Practice Address - Phone:949-389-9195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21707122300000X
TX30982122300000X
CADDS103682122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist