Provider Demographics
NPI:1013220086
Name:FARAHANI, SHEILA MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:MARIE
Last Name:FARAHANI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3818 SPICEWOOD SPRINGS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8969
Mailing Address - Country:US
Mailing Address - Phone:206-293-7915
Mailing Address - Fax:
Practice Address - Street 1:15613 BEL RED RD
Practice Address - Street 2:BUILDING B, SUITE C
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008
Practice Address - Country:US
Practice Address - Phone:425-869-7560
Practice Address - Fax:425-869-7699
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60168215122300000X
CA59570122300000X
TX31694122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist