Provider Demographics
NPI:1568771541
Name:HIRANI, FARIDA
Entity Type:Individual
Prefix:
First Name:FARIDA
Middle Name:
Last Name:HIRANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1152 INDIAN RUN DR
Mailing Address - Street 2:APT. 807
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-1175
Mailing Address - Country:US
Mailing Address - Phone:678-478-5903
Mailing Address - Fax:
Practice Address - Street 1:838 S CARRIER PKWY
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-1517
Practice Address - Country:US
Practice Address - Phone:214-247-7255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX260171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice