Provider Demographics
NPI:1184724940
Name:AIROOD, BASEM M (DDS)
Entity type:Individual
Prefix:DR
First Name:BASEM
Middle Name:M
Last Name:AIROOD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17931 MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6505
Mailing Address - Country:US
Mailing Address - Phone:949-862-0028
Mailing Address - Fax:949-862-0038
Practice Address - Street 1:17931 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6505
Practice Address - Country:US
Practice Address - Phone:949-862-0028
Practice Address - Fax:949-862-0038
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA497221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice