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28940 Golden Lantern Ste H Laguna Niguel CA 92677-1577 | |
(949) 363-2010 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 28940 Golden Lantern Ste H, Laguna Niguel, California |
Authorized Official Name and Position | Azadeh Ashtiany (OWNER DENTIST) |
Authorized Official Contact | 9493632010 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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28940 Golden Lantern Ste H Laguna Niguel CA 92677-1577 Ph: (949) 363-2010 | 28940 Golden Lantern Ste H Laguna Niguel CA 92677-1577 Ph: (949) 363-2010 |
NPI Number | 1538723150 |
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Provider Enumeration Date | 04/29/2019 |
Last Update Date | 11/08/2024 |
Medicare PECOS PAC ID | 2567896632 |
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Medicare Enrollment ID | O20191224000056 |
Identifier | Type | State | Issuer |
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1538723150 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Provider Name | Azadeh Ashtiany |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1639508278 PECOS PAC ID: 3476987546 Enrollment ID: I20200117000211 |
Balaze & Gregg Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 30131 Town Center Dr Ste 250, Laguna Niguel, CA 92677 Phone: 949-770-7686 | |
Glenn P. Frial, Dds, Ms, A Professional Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 28202 Cabot Rd, Suite 250, Laguna Niguel, CA 92677 Phone: 949-276-2105 Fax: 949-276-2109 |