| H. Jahangiri Dental Corporation | |
|
23361 El Toro Rd Ste 117 Lake Forest CA 92630-4810 | |
| (949) 830-3743 | |
| (949) 830-6077 |
| Full Name | H. Jahangiri Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 23361 El Toro Rd Ste 117, Lake Forest, California |
| Authorized Official Name and Position | Hossein Jahangiri (OWNER/DENTIST) |
| Authorized Official Contact | 9498303743 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| H. Jahangiri Dental Corporation 23361 El Toro Rd Ste #117 Lake Forest CA 92630 Ph: (949) 830-3743 | H. Jahangiri Dental Corporation 23361 El Toro Rd Ste 117 Lake Forest CA 92630-4810 Ph: (949) 830-3743 |
| NPI Number | 1255447132 |
|---|---|
| Provider Enumeration Date | 08/22/2006 |
| Last Update Date | 06/21/2019 |
| Medicare PECOS PAC ID | 3779819503 |
|---|---|
| Medicare Enrollment ID | O20190731001966 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255447132 | NPI | - | NPPES |
| 204988678 | Other | CA | TAX ID # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 43611 (California) | Primary |
| Provider Name | Hossein Jahangiri |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1467566737 PECOS PAC ID: 7214263045 Enrollment ID: I20190731002041 |
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