Provider Demographics
NPI:1750023198
Name:CORNERSTONE DENTAL SPECIALTIES INC
Entity Type:Organization
Organization Name:CORNERSTONE DENTAL SPECIALTIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:REZA
Authorized Official - Last Name:ABEDI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-230-7692
Mailing Address - Street 1:9950 IRVINE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4357
Mailing Address - Country:US
Mailing Address - Phone:949-468-6330
Mailing Address - Fax:
Practice Address - Street 1:2096 FORD PKWY
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-1813
Practice Address - Country:US
Practice Address - Phone:651-237-9913
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental