Provider Demographics
NPI:1679726186
Name:MIZRAHI, PARVAZ FARNAD (DDS)
Entity Type:Individual
Prefix:DR
First Name:PARVAZ
Middle Name:FARNAD
Last Name:MIZRAHI
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 1:99 N LA CIENEGA BLVD STE 308
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2286
Mailing Address - Country:US
Mailing Address - Phone:310-652-6491
Mailing Address - Fax:310-652-6492
Practice Address - Street 1:99 N LA CIENEGA BLVD STE 308
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2286
Practice Address - Country:US
Practice Address - Phone:310-652-6491
Practice Address - Fax:310-652-6492
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA530621223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery