Provider Demographics
NPI:1821293465
Name:FARZIN, SINA PETER (DDS)
Entity Type:Individual
Prefix:
First Name:SINA
Middle Name:PETER
Last Name:FARZIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 42ND STREET NW
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016
Mailing Address - Country:US
Mailing Address - Phone:202-244-6650
Mailing Address - Fax:
Practice Address - Street 1:4545 42ND STREET NW
Practice Address - Street 2:SUITE 108
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016
Practice Address - Country:US
Practice Address - Phone:202-244-6650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD125181223P0300X
DC10004991223P0300X
NY473361223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics