Provider Demographics
NPI:1891903084
Name:MAHIN G FARZIN DDS INC
Entity Type:Organization
Organization Name:MAHIN G FARZIN DDS INC
Other - Org Name:DESIGN DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:FARZIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-274-2799
Mailing Address - Street 1:220 NEWPORT CENTER DR
Mailing Address - Street 2:#3
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7506
Mailing Address - Country:US
Mailing Address - Phone:949-274-2799
Mailing Address - Fax:949-759-1871
Practice Address - Street 1:220 NEWPORT CENTER DR
Practice Address - Street 2:#3
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7506
Practice Address - Country:US
Practice Address - Phone:949-274-2799
Practice Address - Fax:949-759-1871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52980305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA52980OtherSTATE LICENSE
CA52980OtherSTATE LICENSE