Provider Demographics
NPI:1114223153
Name:FARANGIS PARTOVI DDS, INCORPORATED
Entity Type:Organization
Organization Name:FARANGIS PARTOVI DDS, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:FARANGIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PARTOVI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MS
Authorized Official - Phone:310-422-9049
Mailing Address - Street 1:6914 LOS VERDES DR APT 1
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-5643
Mailing Address - Country:US
Mailing Address - Phone:310-422-9049
Mailing Address - Fax:
Practice Address - Street 1:6914 LOS VERDES DR APT 1
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-5643
Practice Address - Country:US
Practice Address - Phone:310-422-9049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA462091223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty