Provider Demographics
NPI:1639474604
Name:MAHRAN, SORAYA KARAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:SORAYA
Middle Name:KARAM
Last Name:MAHRAN
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 1:15635 ALTON PKWY
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3309
Mailing Address - Country:US
Mailing Address - Phone:310-854-2779
Mailing Address - Fax:
Practice Address - Street 1:15635 ALTON PKWY
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3309
Practice Address - Country:US
Practice Address - Phone:310-854-2779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-21
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60096122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist