Provider Demographics
NPI:1295035848
Name:EBRAHIMIAN, ARIANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARIANA
Middle Name:
Last Name:EBRAHIMIAN
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 1:5 ERBA LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:SCOTTS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95066-4193
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5 ERBA LN
Practice Address - Street 2:SUITE A
Practice Address - City:SCOTTS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95066-4193
Practice Address - Country:US
Practice Address - Phone:831-438-4411
Practice Address - Fax:831-438-1323
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55910122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist