Provider Demographics
NPI:1609640945
Name:BARFIAN NAMAGERDI, NAREGA
Entity Type:Individual
Prefix:
First Name:NAREGA
Middle Name:
Last Name:BARFIAN NAMAGERDI
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 1:10348 MATHER AVE
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-3134
Mailing Address - Country:US
Mailing Address - Phone:818-233-4413
Mailing Address - Fax:
Practice Address - Street 1:10348 MATHER AVE
Practice Address - Street 2:
Practice Address - City:SUNLAND
Practice Address - State:CA
Practice Address - Zip Code:91040-3134
Practice Address - Country:US
Practice Address - Phone:818-233-4413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDH32867124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist