Provider Demographics
NPI:1871475335
Name:DREAM DENTAL TEAM
Entity type:Organization
Organization Name:DREAM DENTAL TEAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROYA
Authorized Official - Middle Name:
Authorized Official - Last Name:YAVARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-247-6387
Mailing Address - Street 1:16915 SONOMA RDG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-3804
Mailing Address - Country:US
Mailing Address - Phone:949-247-6387
Mailing Address - Fax:
Practice Address - Street 1:8202 N LOOP 1604 W STE 104
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2898
Practice Address - Country:US
Practice Address - Phone:210-694-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty