Provider Demographics
NPI:1497264824
Name:FARIBA SALEHANI DDS,INC
Entity Type:Organization
Organization Name:FARIBA SALEHANI DDS,INC
Other - Org Name:SMILE MAKERS DENTAL OFFICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FARIBA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEHANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:213-908-6655
Mailing Address - Street 1:2105 BEVERLY BLVD STE 229
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-2283
Mailing Address - Country:US
Mailing Address - Phone:213-908-6655
Mailing Address - Fax:213-908-6652
Practice Address - Street 1:2105 BEVERLY BLVD STE 229
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2283
Practice Address - Country:US
Practice Address - Phone:213-908-6655
Practice Address - Fax:213-908-6652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA469491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty