Mahyar Mahboub DDS, a Professional Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

45586 Issued in CA

Legal business name

MAHYAR MAHBOUB DDS, A PROFESSIONAL CORPORATION

Practice address

4902 Irvine Center Dr
Suite 202
Irvine, CA 92604-3305

Phone

(949) 653-6318

Fax

(949) 653-6374

NPI assigned

May 23, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mahyar Mahboub, DDSNPI 1396800363

Title

President

Phone

(949) 653-6318

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mahyar Mahboub, D.D.S.

  • General Practice Dentistry
  • Irvine, CA
  • NPI 1396800363
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306056544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4902 IRVINE CENTER DR",
            "address_2": "SUITE 202",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926043305",
            "telephone_number": "949-653-6318",
            "fax_number": "949-653-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4902 IRVINE CENTER DR",
            "address_2": "SUITE 202",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926043305",
            "telephone_number": "949-653-6318",
            "fax_number": "949-653-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHYAR MAHBOUB DDS, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAHBOUB",
        "authorized_official_first_name": "MAHYAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-653-6318",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G-92967-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nazik Mahmoud
• Judy Renee Mahoney, PH.D.
• Soraya Karam Mahran, DDS
• Reza Mahrou, M.D.
• Carlee Mahurin
• Ann Lan Mai, MD
• Thanh Trang Mai
• Thao Phuong Nguyen Mai, PHARM.D.
• Tiffany Mai, CCC-SLP
• Palesa Haka Maieane

• General Practice Dentistry in Irvine, CA
• Providers in Irvine, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.