Provider Demographics
NPI:1972154417
Name:FARSHAD SEYEDEIN DDS INC
Entity Type:Organization
Organization Name:FARSHAD SEYEDEIN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ENDODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:FARSHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SEYEDEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-767-1353
Mailing Address - Street 1:820 S WILDFLOWER LN
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92808-2300
Mailing Address - Country:US
Mailing Address - Phone:714-767-1353
Mailing Address - Fax:
Practice Address - Street 1:13420 NEWPORT AVE STE H
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3745
Practice Address - Country:US
Practice Address - Phone:714-852-3626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty