Provider Demographics
NPI:1790208692
Name:FALAKI, FARNAZ (DDS)
Entity Type:Individual
Prefix:
First Name:FARNAZ
Middle Name:
Last Name:FALAKI
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 1:350 N PALM DR APT 306
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5923
Mailing Address - Country:US
Mailing Address - Phone:858-353-8859
Mailing Address - Fax:
Practice Address - Street 1:350 N PALM DR APT 306
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5923
Practice Address - Country:US
Practice Address - Phone:858-353-8859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2795615258122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist