Provider Demographics
NPI:1760026579
Name:ARYAFAR, GELAREH (DMD)
Entity Type:Individual
Prefix:
First Name:GELAREH
Middle Name:
Last Name:ARYAFAR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2724 KIPLING ST APT 739
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-1774
Mailing Address - Country:US
Mailing Address - Phone:617-755-1027
Mailing Address - Fax:
Practice Address - Street 1:11020 AIRLINE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77037-1112
Practice Address - Country:US
Practice Address - Phone:281-272-1959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX357891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice