Provider Demographics
NPI:1598922536
Name:GOLESTANI, FARIDEH (DDS)
Entity Type:Individual
Prefix:
First Name:FARIDEH
Middle Name:
Last Name:GOLESTANI
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 1:471 W MOUNT PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1720
Mailing Address - Country:US
Mailing Address - Phone:973-597-1818
Mailing Address - Fax:973-597-1817
Practice Address - Street 1:471 W MOUNT PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-1720
Practice Address - Country:US
Practice Address - Phone:973-597-1818
Practice Address - Fax:973-597-1817
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ189371223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry