Matt G. Farzin DDS, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

53595 Issued in CA

Legal business name

MATT G. FARZIN DDS, INC

Practice address

2969 Harbor Blvd.
Costa Mesa, CA 92626

Phone

(714) 437-1100

Fax

(714) 437-1101

NPI assigned

May 10, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Matt G Farzin, DDSNPI 1386783108

Title

Dentist

Phone

(949) 812-8014

Specialties & licenses 1

Addresses

Other names 1

• Smile Max Dental Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Matt G Farzin, DDS

  • General Practice Dentistry
  • Costa Mesa, CA
  • NPI 1386783108
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1487913471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2969 HARBOR BLVD",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263912",
            "telephone_number": "714-437-1100",
            "fax_number": "714-437-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2969 HARBOR BLVD.",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92626",
            "telephone_number": "714-437-1100",
            "fax_number": "714-437-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATT G. FARZIN DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-10",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "FARZIN",
        "authorized_official_first_name": "MATT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "949-812-8014",
        "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": "53595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Max Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Grace Matin, FNP-C
• Maximiliano H Matos, M.D.
• Matrix Rehabilitation, Inc.
• Jasmine Matsumoto
• Kellen Matsuno, DPT
• Matthew M. DO. DPM a Proffesional Corporation
• Miesha Patrice Matthews
• Lucina Antonia Mattila
• Xavier Joshua Matus
• Alina Matutes, FNP

• General Practice Dentistry in Costa Mesa, CA
• Providers in Costa Mesa, 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 May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.