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PERIODONTICS ORAL AND FACIAL SURGICAL SPECIALTIES NPI 1386234284


NPI Information

NPI: 1386234284
Provider Name: PERIODONTICS, ORAL AND FACIAL SURGICAL SPECIALTIES
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
29829 SANTA MARGARITA PKWY STE 300
RANCHO SANTA MARGARITA, CA
ZIP 92688
Phone: (949) 888-0332
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PERIODONTICS, ORAL AND FACIAL SURGICAL SPECIALTIES is an oral and maxillofacial surgery dentist in Rancho Santa Margarita, CA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. PERIODONTICS, ORAL AND FACIAL SURGICAL SPECIALTIES NPI is 1386234284. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

29829 SANTA MARGARITA PKWY STE 300
RANCHO SANTA MARGARITA, CA
ZIP 92688-623
Phone: (949) 888-0332
Fax: (949) 888-0400

The provider's authorized official is Reza Bolourian .
The authorized official title is Owner and has the following contact phone number (949) 888-0332.

The enumeration date for this NPI number is 1/25/2021 and was last updated on 1/25/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0300XDentistPeriodonticsNo
2261QD0000XClinic/CenterDentalNo
3261QS0112XClinic/CenterOral and Maxillofacial SurgeryNo
41223S0112XDentistOral and Maxillofacial SurgeryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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