Provider Demographics
NPI:1063486298
Name:AZER, SOHEIR S (DDS)
Entity type:Individual
Prefix:
First Name:SOHEIR
Middle Name:S
Last Name:AZER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 PLACENTIA AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3301
Mailing Address - Country:US
Mailing Address - Phone:949-548-9000
Mailing Address - Fax:949-548-9001
Practice Address - Street 1:355 PLACENTIA AVE STE 105
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3301
Practice Address - Country:US
Practice Address - Phone:949-548-9000
Practice Address - Fax:949-548-9001
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA425211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice