Provider Demographics
NPI:1407129596
Name:SHAHANI, FARANAK (DMD)
Entity Type:Individual
Prefix:DR
First Name:FARANAK
Middle Name:
Last Name:SHAHANI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 ALMA ST.
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306
Mailing Address - Country:US
Mailing Address - Phone:650-494-1900
Mailing Address - Fax:650-494-1902
Practice Address - Street 1:3515 ALMA ST
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-3539
Practice Address - Country:US
Practice Address - Phone:650-494-1900
Practice Address - Fax:650-494-1900
Is Sole Proprietor?:No
Enumeration Date:2012-02-20
Last Update Date:2017-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA610611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA61061OtherDENTAL BOARD OF CALIFORNIA