Provider Demographics
NPI:1790953024
Name:FARHAD PARTOVI DDS INC
Entity Type:Organization
Organization Name:FARHAD PARTOVI DDS INC
Other - Org Name:OAKLAND DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FARHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:PARTOVI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-532-8995
Mailing Address - Street 1:2648 INTERNATIONAL BLVD # 602
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-1506
Mailing Address - Country:US
Mailing Address - Phone:510-532-8995
Mailing Address - Fax:
Practice Address - Street 1:2648 INTERNATIONAL BLVD # 602
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-1506
Practice Address - Country:US
Practice Address - Phone:510-532-8995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA415101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB41510Medicare UPIN