Provider Demographics
NPI:1417060385
Name:YOUNAI, FARIBA S (DDS)
Entity Type:Individual
Prefix:DR
First Name:FARIBA
Middle Name:S
Last Name:YOUNAI
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 1:10833 LE CONTE AVE #A0125CHS
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-3075
Mailing Address - Country:US
Mailing Address - Phone:310-825-8879
Mailing Address - Fax:310-825-2124
Practice Address - Street 1:10833 LE CONTE AVE # AO125CHS
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-3075
Practice Address - Country:US
Practice Address - Phone:310-825-8879
Practice Address - Fax:310-825-2124
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45421122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU74295Medicare UPIN