Provider Demographics
NPI:1316702491
Name:NILFORUSHAN, ARIAN
Entity type:Individual
Prefix:
First Name:ARIAN
Middle Name:
Last Name:NILFORUSHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21736 MIRADOR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-1137
Mailing Address - Country:US
Mailing Address - Phone:949-310-8698
Mailing Address - Fax:
Practice Address - Street 1:21736 MIRADOR
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-1137
Practice Address - Country:US
Practice Address - Phone:949-310-8698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110105122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist