| Roya Nematollahi D.d.s. Inc | |
|
14122 Red Hill Ave Tustin CA 92780-5834 | |
| (714) 544-8338 | |
| (714) 573-1062 |
| Full Name | Roya Nematollahi D.d.s. Inc |
|---|---|
| Speciality | Dentist |
| Location | 14122 Red Hill Ave, Tustin, California |
| Authorized Official Name and Position | Roya Nematollahi (DENTIST/OWNER) |
| Authorized Official Contact | 7145448338 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roya Nematollahi D.d.s. Inc 14122 Red Hill Ave Tustin CA 92780-5834 Ph: (714) 544-8338 | Roya Nematollahi D.d.s. Inc 14122 Red Hill Ave Tustin CA 92780-5834 Ph: (714) 544-8338 |
| NPI Number | 1326462730 |
|---|---|
| Provider Enumeration Date | 02/06/2014 |
| Last Update Date | 02/06/2014 |
| Medicare PECOS PAC ID | 3870840036 |
|---|---|
| Medicare Enrollment ID | O20180718003009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326462730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 54181 (California) | Primary |
| Provider Name | Roya Nematollahi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1780863266 PECOS PAC ID: 4789931940 Enrollment ID: I20180718003064 |
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