Provider Demographics
NPI:1023679222
Name:QURESHI, EMAAN (DMD)
Entity type:Individual
Prefix:
First Name:EMAAN
Middle Name:
Last Name:QURESHI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2241 CRANBERRY RD
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6828
Mailing Address - Country:US
Mailing Address - Phone:859-608-9844
Mailing Address - Fax:
Practice Address - Street 1:23704 EL TORO RD STE A
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-8906
Practice Address - Country:US
Practice Address - Phone:949-770-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.025885122300000X
CA105776122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist