Provider Demographics
NPI:1780702936
Name:HAROONIAN, OMID (DDS)
Entity type:Individual
Prefix:
First Name:OMID
Middle Name:
Last Name:HAROONIAN
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 1:1901 WESTCLIFF DR.#6
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660
Mailing Address - Country:US
Mailing Address - Phone:310-382-0633
Mailing Address - Fax:949-646-2220
Practice Address - Street 1:1901 WESTCLIFF DR STE 6
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5505
Practice Address - Country:US
Practice Address - Phone:310-382-0633
Practice Address - Fax:949-646-2220
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54149122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist