Provider Demographics
NPI:1790404796
Name:SHARIATI, FARNIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:FARNIA
Middle Name:
Last Name:SHARIATI
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 1:3 WOODCOCK RD UNIT 2101
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-1088
Mailing Address - Country:US
Mailing Address - Phone:850-510-8617
Mailing Address - Fax:
Practice Address - Street 1:7400 ABERCORN ST STE 8
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2447
Practice Address - Country:US
Practice Address - Phone:912-542-0432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN122856122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist