Provider Demographics
NPI:1750050795
Name:JAVID OSAFI DMD INC
Entity Type:Organization
Organization Name:JAVID OSAFI DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVID
Authorized Official - Middle Name:FARAN
Authorized Official - Last Name:OSAFI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-612-0687
Mailing Address - Street 1:4980 BARRANCA PKWY STE 206
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-8655
Mailing Address - Country:US
Mailing Address - Phone:702-612-0687
Mailing Address - Fax:
Practice Address - Street 1:4980 BARRANCA PKWY STE 206
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-8655
Practice Address - Country:US
Practice Address - Phone:702-612-0687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty