Provider Demographics
NPI:1578919726
Name:FARAHI, ARIEL (DMD, MD)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:FARAHI
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6614 ABBOTTSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-3108
Mailing Address - Country:US
Mailing Address - Phone:310-367-4212
Mailing Address - Fax:
Practice Address - Street 1:6614 ABBOTTSWOOD DR
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-3108
Practice Address - Country:US
Practice Address - Phone:310-367-4212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-06
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1046851223S0112X
TX386701223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty