Farzin Sean Farshidi, DDS MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DDS63573 Issued in CA

Practice address

17452 Irvine Blvd Ste 100
Tustin, CA 92780-3031

Phone

(949) 310-5888

NPI assigned

Jun 17, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1750676755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17452 IRVINE BLVD STE 100",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803031",
            "telephone_number": "949-310-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17452 IRVINE BLVD STE 100",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803031",
            "telephone_number": "949-310-5888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13362 Newport Ave Ste G",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927803427",
            "country_code": "US",
            "telephone_number": "714-838-4141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2401 W Chapman Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928682327",
            "country_code": "US",
            "telephone_number": "714-939-7505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2401 W Chapman Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928682327",
            "country_code": "US",
            "telephone_number": "714-939-7505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARSHIDI",
        "first_name": "FARZIN",
        "middle_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "DDS MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-17",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "DDS63573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Tustin, CA
• Providers in Tustin, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.