Provider Demographics
NPI:1356664189
Name:KIANI, FARHAD (DDS)
Entity Type:Individual
Prefix:
First Name:FARHAD
Middle Name:
Last Name:KIANI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 CALIFORNIA AVE
Mailing Address - Street 2:SUITE 400-B
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-7024
Mailing Address - Country:US
Mailing Address - Phone:661-459-1900
Mailing Address - Fax:
Practice Address - Street 1:4900 CALIFORNIA AVE
Practice Address - Street 2:SUITE 400-B
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-7024
Practice Address - Country:US
Practice Address - Phone:661-459-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA591721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice