Provider Demographics
NPI:1639694227
Name:DR. HORIYAT, A DENTAL CORPORATION
Entity Type:Organization
Organization Name:DR. HORIYAT, A DENTAL CORPORATION
Other - Org Name:ARIA DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HORIYAT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-364-9600
Mailing Address - Street 1:27652 CROWN VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6522
Mailing Address - Country:US
Mailing Address - Phone:949-364-9600
Mailing Address - Fax:949-364-9300
Practice Address - Street 1:27652 CROWN VALLEY PARKWAY
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-364-9600
Practice Address - Fax:949-364-9300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1215052410OtherNPI