Provider Demographics
NPI:1407912082
Name:SAGHATCHI, FARSHAD (DDS)
Entity type:Individual
Prefix:DR
First Name:FARSHAD
Middle Name:
Last Name:SAGHATCHI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 NEWPORT BLVD STE E267
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-5013
Mailing Address - Country:US
Mailing Address - Phone:949-574-0100
Mailing Address - Fax:949-574-0101
Practice Address - Street 1:1835 NEWPORT BLVD STE E267
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-5013
Practice Address - Country:US
Practice Address - Phone:949-574-0100
Practice Address - Fax:949-574-0101
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45970122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist