Provider Demographics
NPI:1699202531
Name:ZAERY KALANTARI DENTAL GROUP INC
Entity Type:Organization
Organization Name:ZAERY KALANTARI DENTAL GROUP INC
Other - Org Name:SUNSHINE SMILES OF ORANGE COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARRAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAERY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-486-7641
Mailing Address - Street 1:27725 SANTA MARGARITA PKWY STE 270
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6708
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:27725 SANTA MARGARITA PKWY STE 270
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:949-951-0951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-22
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA533621223G0001X
CA600591223G0001X
CA604491223P0221X
CA650871223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty