Organization
BIG DENTAL GROUP
Active
Other names
Bigdeli DDS Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARANAK BIGDELI DDS (OWNER)
(714) 968-3522
Entity
Organization
Contact information
Practice address
18682 BEACH BLVD, STE #100, HUNTINGTON BEACH, CA 92648
(714) 968-3522
(714) 968-3577
Mailing address
18682 BEACH BLVD, STE #100, HUNTINGTON BEACH, CA 92648
(714) 968-3522
(714) 968-3577
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
46753
CA
122300000X
Dentist
Primary
49260
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G9350701
MEDICAL
CA
Enumeration date
07/31/2006
Last updated
08/22/2020
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