Provider Demographics
NPI:1346486107
Name:HEMAT, FARIBA (DDS)
Entity Type:Individual
Prefix:DR
First Name:FARIBA
Middle Name:
Last Name:HEMAT
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 1:12441 MAGNOLIA ST STE E
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92841-3300
Mailing Address - Country:US
Mailing Address - Phone:714-539-9939
Mailing Address - Fax:714-539-9720
Practice Address - Street 1:12441 MAGNOLIA ST STE E
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-3300
Practice Address - Country:US
Practice Address - Phone:714-539-9939
Practice Address - Fax:714-539-9720
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50755122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist