Provider Demographics
NPI:1467776427
Name:BOKHOUR, FARINAZ (DDS)
Entity Type:Individual
Prefix:DR
First Name:FARINAZ
Middle Name:
Last Name:BOKHOUR
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 1:1548 GRANVILLE AVE
Mailing Address - Street 2:APT #5
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-2883
Mailing Address - Country:US
Mailing Address - Phone:310-210-6718
Mailing Address - Fax:310-826-7797
Practice Address - Street 1:1548 GRANVILLE AVE
Practice Address - Street 2:APT #5
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-2883
Practice Address - Country:US
Practice Address - Phone:310-210-6718
Practice Address - Fax:310-826-7797
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58960122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist