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Ninousha Basti, DDS
General Practice Dentistry in San Clemente, California
NPI 1164551800

Ninousha Basti is a General Practice Dentistry based in San Clemente, CA and is specialized in General Practice. Ninousha Basti practices in San Clemente, CA and has the professional credentials of DDS. The NPI Number for Ninousha Basti is 1164551800 and holds a License No. 55294 (California).

The current practice location address for Ninousha Basti is 150 Avendia Del Mar, Ste. C, San Clemente, CA and can be reached out via phone at 949-347-0780 and via fax at 949-347-9549.

Location: 150 Avendia Del Mar, Ste. C, San Clemente, CA, 92672
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164551800
Provider Name
Ninousha Basti
Credential
DDS
Provider Entity Type
Individual
Gender
Female
Address
150 Avendia Del Mar, Ste. C, San Clemente, CA, 92672
Phone Number
949-347-0780
Fax Number
949-347-9549
Provider Enumeration Date
03/05/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
55294 01 CA DENTAL LICENSE
institution
Provider Business Practice Location Address Details
Address
150 Avendia Del Mar, Ste. C
City
San Clemente
State
California
Zip
92672
Phone Number
949-347-0780
Fax Number
949-347-9549
person
Provider Business Mailing Address Details
Address
150 Avendia Del Mar, Ste. C
City
San Clemente
State
California
Zip
92672
Phone Number
949-347-0780
Fax Number
949-347-9549
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
55294 (California)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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