Provider Demographics
NPI:1649366899
Name:HEJAZI, PARISA (DMD)
Entity type:Individual
Prefix:DR
First Name:PARISA
Middle Name:
Last Name:HEJAZI
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 1:14370 CULVER DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-0307
Mailing Address - Country:US
Mailing Address - Phone:949-551-6555
Mailing Address - Fax:
Practice Address - Street 1:923 W CARSON ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2003
Practice Address - Country:US
Practice Address - Phone:310-533-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41086122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist