Provider Demographics
NPI:1174680243
Name:KNAPP, FARIDEH TAGHILOU (DDS)
Entity Type:Individual
Prefix:DR
First Name:FARIDEH
Middle Name:TAGHILOU
Last Name:KNAPP
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 1:13600 MARINA POINTE DR UNIT 1014
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-9252
Mailing Address - Country:US
Mailing Address - Phone:310-306-3381
Mailing Address - Fax:
Practice Address - Street 1:6260 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90038-1704
Practice Address - Country:US
Practice Address - Phone:323-465-9055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40255122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist