Provider Demographics
NPI:1376941179
Name:FARNAGHI, AMIR PASHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMIR PASHA
Middle Name:
Last Name:FARNAGHI
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 1:4415 SPECTRUM
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3384
Mailing Address - Country:US
Mailing Address - Phone:949-300-1319
Mailing Address - Fax:
Practice Address - Street 1:6950 N PARAMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-1863
Practice Address - Country:US
Practice Address - Phone:562-278-3080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-09
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29585122300000X
CA105636122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist