Provider Demographics
NPI:1881826170
Name:PEJMAN-ZADEH, PARISA (DDS)
Entity Type:Individual
Prefix:DR
First Name:PARISA
Middle Name:
Last Name:PEJMAN-ZADEH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:PARISA
Other - Middle Name:
Other - Last Name:ZADEH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:14252 CULVER DR # A419
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-0317
Mailing Address - Country:US
Mailing Address - Phone:949-903-0672
Mailing Address - Fax:
Practice Address - Street 1:935 E LA HABRA BLVD
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-5505
Practice Address - Country:US
Practice Address - Phone:562-697-2611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA587121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice