Provider Demographics
NPI:1134890643
Name:MEHRI SAFARI, DDS, A PROFESSIONAL DENTAL CORPORATION
Entity type:Organization
Organization Name:MEHRI SAFARI, DDS, A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MEHRI
Authorized Official - Middle Name:
Authorized Official - Last Name:SARAFI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-848-9200
Mailing Address - Street 1:16511 GOLDENWEST ST STE 101
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-4484
Mailing Address - Country:US
Mailing Address - Phone:714-848-2900
Mailing Address - Fax:714-375-6357
Practice Address - Street 1:16511 GOLDENWEST ST STE 101
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-4484
Practice Address - Country:US
Practice Address - Phone:714-848-2900
Practice Address - Fax:714-375-6357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental