Provider Demographics
NPI:1598214256
Name:ALLAMEH DENTAL CORPORATION
Entity Type:Organization
Organization Name:ALLAMEH DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FARZIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLAMEH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-706-1711
Mailing Address - Street 1:21149 NEWPORT COAST DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT COAST
Mailing Address - State:CA
Mailing Address - Zip Code:92657-1122
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21149 NEWPORT COAST DR
Practice Address - Street 2:
Practice Address - City:NEWPORT COAST
Practice Address - State:CA
Practice Address - Zip Code:92657-1122
Practice Address - Country:US
Practice Address - Phone:949-706-1711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60126122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty