Provider Demographics
NPI:1962508572
Name:DARYABEGI, YASMIN (DMD, MSCD)
Entity Type:Individual
Prefix:
First Name:YASMIN
Middle Name:
Last Name:DARYABEGI
Suffix:
Gender:F
Credentials:DMD, MSCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23631 TRINIDAD LN
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-4667
Mailing Address - Country:US
Mailing Address - Phone:617-699-1234
Mailing Address - Fax:
Practice Address - Street 1:23631 TRINIDAD LN
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-4667
Practice Address - Country:US
Practice Address - Phone:617-699-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA525451223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics