Provider Demographics
NPI:1710691506
Name:RAHIMI, FARZANEH (DDS)
Entity Type:Individual
Prefix:
First Name:FARZANEH
Middle Name:
Last Name:RAHIMI
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 1:14822 NORMANS CAY CIR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-3444
Mailing Address - Country:US
Mailing Address - Phone:512-888-8867
Mailing Address - Fax:
Practice Address - Street 1:14430 N DALE MARBY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618
Practice Address - Country:US
Practice Address - Phone:813-269-9100
Practice Address - Fax:813-269-9103
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN27640122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist