Provider Demographics
NPI:1356469043
Name:SANAVI, FARSHID (DMD, PHD)
Entity Type:Individual
Prefix:
First Name:FARSHID
Middle Name:
Last Name:SANAVI
Suffix:
Gender:M
Credentials:DMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7814 OLD YORK RD
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2509
Mailing Address - Country:US
Mailing Address - Phone:215-635-6700
Mailing Address - Fax:215-635-1816
Practice Address - Street 1:7814 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2509
Practice Address - Country:US
Practice Address - Phone:215-635-6700
Practice Address - Fax:215-635-1816
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025774L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics