Provider Demographics
NPI:1720336175
Name:SAFI, SORAYA MEENA (DMD)
Entity Type:Individual
Prefix:DR
First Name:SORAYA
Middle Name:MEENA
Last Name:SAFI
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 1:14123 SPECTRUM
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3406
Mailing Address - Country:US
Mailing Address - Phone:951-255-0966
Mailing Address - Fax:
Practice Address - Street 1:18432 YORBA LINDA BLVD STE D
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-4008
Practice Address - Country:US
Practice Address - Phone:951-255-0966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61787122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist