Provider Demographics
NPI:1437598612
Name:FARHANGI, SAHEL (DDS)
Entity Type:Individual
Prefix:
First Name:SAHEL
Middle Name:
Last Name:FARHANGI
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 1:3580 W GRANT LINE RD UNIT 921
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95304-9626
Mailing Address - Country:US
Mailing Address - Phone:703-798-0766
Mailing Address - Fax:
Practice Address - Street 1:3580 W GRANT LINE RD UNIT 921
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95304-9626
Practice Address - Country:US
Practice Address - Phone:703-956-9444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-20
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.024003122300000X
FLDN20685122300000X
VA0401414734122300000X
CA102951122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist