Provider Demographics
NPI:1811027006
Name:GAMINCHI, FARINOUSH (DMD)
Entity Type:Individual
Prefix:DR
First Name:FARINOUSH
Middle Name:
Last Name:GAMINCHI
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 1:2425 COLORADO AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-3584
Mailing Address - Country:US
Mailing Address - Phone:310-829-3898
Mailing Address - Fax:310-829-0443
Practice Address - Street 1:2425 COLORADO AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-3584
Practice Address - Country:US
Practice Address - Phone:310-829-3898
Practice Address - Fax:310-829-0443
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA414071223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics