Provider Demographics
NPI:1467633164
Name:F ESFANDIARI DENTAL CORPORATION
Entity Type:Organization
Organization Name:F ESFANDIARI DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARSHID
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:ESFANDIARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-777-7717
Mailing Address - Street 1:166 N MOORPARK RD STE 204
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4420
Mailing Address - Country:US
Mailing Address - Phone:805-777-7717
Mailing Address - Fax:805-777-7727
Practice Address - Street 1:166 N MOORPARK RD STE 204
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360
Practice Address - Country:US
Practice Address - Phone:805-777-7717
Practice Address - Fax:805-777-7727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty