Provider Demographics
NPI:1558585109
Name:F.MANAVI,D.D.S.,INC.
Entity Type:Organization
Organization Name:F.MANAVI,D.D.S.,INC.
Other - Org Name:DENTAL GROUP OF ARCADIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MANAVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-447-5126
Mailing Address - Street 1:440 E HUNTINGTON DR STE 101
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3750
Mailing Address - Country:US
Mailing Address - Phone:626-447-5126
Mailing Address - Fax:626-447-0077
Practice Address - Street 1:440 E HUNTINGTON DR STE 101
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3750
Practice Address - Country:US
Practice Address - Phone:626-447-5126
Practice Address - Fax:626-447-0077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA385581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty