Provider Demographics
NPI:1669674677
Name:BEHROOZI, PARISA (DDS)
Entity Type:Individual
Prefix:DR
First Name:PARISA
Middle Name:
Last Name:BEHROOZI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:PARISA
Other - Middle Name:
Other - Last Name:BEHROOZI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:119 DANBROOK
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92603-1024
Mailing Address - Country:US
Mailing Address - Phone:714-815-0012
Mailing Address - Fax:
Practice Address - Street 1:119 DANBROOK
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92603-1024
Practice Address - Country:US
Practice Address - Phone:714-815-0012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA460261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice