Provider Demographics
NPI:1821258278
Name:PAYAM C ATAII, DMD, INC
Entity Type:Organization
Organization Name:PAYAM C ATAII, DMD, INC
Other - Org Name:LASER DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAYAM
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:ATAII
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:949-707-5273
Mailing Address - Street 1:24881 ALICIA PKWY STE G
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-4617
Mailing Address - Country:US
Mailing Address - Phone:949-707-5273
Mailing Address - Fax:949-707-5213
Practice Address - Street 1:24881 ALICIA PKWY
Practice Address - Street 2:SUITE # H
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-4617
Practice Address - Country:US
Practice Address - Phone:949-707-5273
Practice Address - Fax:949-707-5213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA441401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty