Provider Demographics
NPI:1609283126
Name:FERESHTEH KHEYRDAN , D.D.S., INC.
Entity Type:Organization
Organization Name:FERESHTEH KHEYRDAN , D.D.S., INC.
Other - Org Name:PEARL DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FERESHTEH
Authorized Official - Middle Name:
Authorized Official - Last Name:KHEYRDAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-662-7898
Mailing Address - Street 1:5405 ALTON PKWY
Mailing Address - Street 2:#317
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-3717
Mailing Address - Country:US
Mailing Address - Phone:714-662-7898
Mailing Address - Fax:
Practice Address - Street 1:3620 S BRISTOL ST
Practice Address - Street 2:SUIT # 104
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-7300
Practice Address - Country:US
Practice Address - Phone:174-662-7898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty