| Evan Georgieff, Dds, Inc. | |
|
620 W Edinger Ave Santa Ana CA 92707 | |
| (714) 668-1602 | |
| (714) 540-4683 |
| Full Name | Evan Georgieff, Dds, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 620 W Edinger Ave, Santa Ana, California |
| Authorized Official Name and Position | Evan Paul Georgieff (OWNER/DENTIST) |
| Authorized Official Contact | 9494127900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evan Georgieff, Dds, Inc. 620 W Edinger Ave Santa Ana CA 92707 Ph: (714) 668-1602 | Evan Georgieff, Dds, Inc. 620 W Edinger Ave Santa Ana CA 92707 Ph: (714) 668-1602 |
| NPI Number | 1194899864 |
|---|---|
| Provider Enumeration Date | 11/17/2006 |
| Last Update Date | 10/20/2015 |
| Medicare PECOS PAC ID | 1456615996 |
|---|---|
| Medicare Enrollment ID | O20180508002398 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194899864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | B38528 (California) | Primary |
| Provider Name | Evan P Georgieff |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1144367699 PECOS PAC ID: 2264796705 Enrollment ID: I20180508002510 |
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