Provider Demographics
NPI:1528407541
Name:DINI, FARNAZ MAZ (DDS)
Entity Type:Individual
Prefix:
First Name:FARNAZ
Middle Name:MAZ
Last Name:DINI
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 1:2401 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-9103
Mailing Address - Country:US
Mailing Address - Phone:713-517-5375
Mailing Address - Fax:
Practice Address - Street 1:13420 STATE HIGHWAY 249
Practice Address - Street 2:#B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77086-3167
Practice Address - Country:US
Practice Address - Phone:281-272-0106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29162122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist