Provider Demographics
NPI:1629448188
Name:FAYE HAZRATI DDS INC
Entity Type:Organization
Organization Name:FAYE HAZRATI DDS INC
Other - Org Name:DR HAZ DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAZRATI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-665-0898
Mailing Address - Street 1:13372 NEWPORT AVE.
Mailing Address - Street 2:STE F
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780
Mailing Address - Country:US
Mailing Address - Phone:714-665-0898
Mailing Address - Fax:
Practice Address - Street 1:13372 NEWPORT AVE
Practice Address - Street 2:STE F
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3426
Practice Address - Country:US
Practice Address - Phone:714-665-0898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-28
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental