Provider Demographics
NPI:1225453327
Name:MEHRFAR, ATOSA (DDS)
Entity Type:Individual
Prefix:
First Name:ATOSA
Middle Name:
Last Name:MEHRFAR
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 1:13079 ARTESIA BLVD STE B120
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-1483
Mailing Address - Country:US
Mailing Address - Phone:562-924-7594
Mailing Address - Fax:
Practice Address - Street 1:13079 ARTESIA BLVD STE B120
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-1483
Practice Address - Country:US
Practice Address - Phone:562-924-7594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-26
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA619711223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics