# AMITISS NASIRI ANSARI DDS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Coast Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912447566
- **Authorized official:** DR. AMITISS NASIRI DDS (DDS/OWNER)
- **Authorized official phone:** (714) 556-7277

## Contact information

- **Practice address:** 2781 W MACARTHUR BLVD, SUITE N, SANTA ANA, CA 92704-8300
- **Practice address phone:** (714) 556-7277
- **Practice address fax:** (714) 556-2021
- **Mailing address:** 2781 W MACARTHUR BLVD, SUITE N, SANTA ANA, CA 92704-8300
- **Mailing address phone:** (714) 556-7277
- **Mailing address fax:** (714) 556-2021

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 55817 | CA | Yes |

## Other

- **Enumeration date:** 03/01/2017
- **Last updated:** 03/01/2017