Provider Demographics
NPI:1770243925
Name:NAGHAVI, SAEID (DDS)
Entity Type:Individual
Prefix:MR
First Name:SAEID
Middle Name:
Last Name:NAGHAVI
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 1:2518 ANACAPA
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-2325
Mailing Address - Country:US
Mailing Address - Phone:171-426-1652
Mailing Address - Fax:
Practice Address - Street 1:2518 ANACAPA
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92602-2325
Practice Address - Country:US
Practice Address - Phone:714-261-6523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107201122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA107201Medicaid