Provider Demographics
NPI:1780226209
Name:DENTAL PRACTICES OF CHARLES ZAHEDI
Entity Type:Organization
Organization Name:DENTAL PRACTICES OF CHARLES ZAHEDI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAHEDI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-922-4450
Mailing Address - Street 1:4590 MACARTHUR BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2028
Mailing Address - Country:US
Mailing Address - Phone:949-922-4450
Mailing Address - Fax:
Practice Address - Street 1:4221 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2016
Practice Address - Country:US
Practice Address - Phone:949-922-4450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty