Provider Demographics
NPI:1174611354
Name:ALLAMEH, FARZIN (DDS)
Entity type:Individual
Prefix:DR
First Name:FARZIN
Middle Name:
Last Name:ALLAMEH
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 1:21149 NEWPORT COAST DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT COAST
Mailing Address - State:CA
Mailing Address - Zip Code:92657-1122
Mailing Address - Country:US
Mailing Address - Phone:949-706-1711
Mailing Address - Fax:
Practice Address - Street 1:21149 NEWPORT COAST DR.
Practice Address - Street 2:
Practice Address - City:NEWPORT COAST
Practice Address - State:CA
Practice Address - Zip Code:92657-1122
Practice Address - Country:US
Practice Address - Phone:949-706-1711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60126122300000X
AZ47131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice