Provider Demographics
NPI:1639522428
Name:YASMEEN, FARAH (DDS)
Entity Type:Individual
Prefix:
First Name:FARAH
Middle Name:
Last Name:YASMEEN
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 1:2420 DEL PASO RD STE 125
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-9678
Mailing Address - Country:US
Mailing Address - Phone:916-333-3534
Mailing Address - Fax:916-333-3991
Practice Address - Street 1:2420 DEL PASO RD STE 125
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-9678
Practice Address - Country:US
Practice Address - Phone:916-333-3534
Practice Address - Fax:916-333-3991
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-18
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100313122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist