Provider Demographics
NPI:1710098736
Name:BATNIJI, SOBHI ALI (DDS)
Entity Type:Individual
Prefix:MR
First Name:SOBHI
Middle Name:ALI
Last Name:BATNIJI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30231 GOLDEN LANTERN ST
Mailing Address - Street 2:STE D
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677
Mailing Address - Country:US
Mailing Address - Phone:949-363-1200
Mailing Address - Fax:949-363-8005
Practice Address - Street 1:30231 GOLDEN LANTERN ST
Practice Address - Street 2:STE D
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677
Practice Address - Country:US
Practice Address - Phone:949-363-1200
Practice Address - Fax:949-363-8005
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA320221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB3202202OtherDENTI CAL