Provider Demographics
NPI:1467538496
Name:RAFATI, SIMA FALSAFI (DDS, MS)
Entity Type:Individual
Prefix:
First Name:SIMA
Middle Name:FALSAFI
Last Name:RAFATI
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 BLOSSOM HILL RD STE E2
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-2701
Mailing Address - Country:US
Mailing Address - Phone:408-226-1234
Mailing Address - Fax:408-213-7676
Practice Address - Street 1:827 BLOSSOM HILL RD STE E2
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-2701
Practice Address - Country:US
Practice Address - Phone:408-226-1234
Practice Address - Fax:408-213-7676
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA420861223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics