Provider Demographics
NPI:1598190944
Name:GHAZAL AND SHARIFIAN DENTAL CORPORATION
Entity Type:Organization
Organization Name:GHAZAL AND SHARIFIAN DENTAL CORPORATION
Other - Org Name:THE DENTAL OFFICE ON RED HILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DDS/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:G
Authorized Official - Last Name:GHAZAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-975-0150
Mailing Address - Street 1:17000 RED HILL AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5626
Mailing Address - Country:US
Mailing Address - Phone:714-845-8890
Mailing Address - Fax:949-474-1495
Practice Address - Street 1:17000 RED HILL AVE
Practice Address - Street 2:SUITE D
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-5626
Practice Address - Country:US
Practice Address - Phone:949-975-0150
Practice Address - Fax:949-975-0170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty