Provider Demographics
NPI:1902020456
Name:FARID PAKRAVAN, D.D.S., II, INC.
Entity Type:Organization
Organization Name:FARID PAKRAVAN, D.D.S., II, INC.
Other - Org Name:DENTAL CENTER OF HIGHLAND PARK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARID
Authorized Official - Middle Name:
Authorized Official - Last Name:PAKRAVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-982-0999
Mailing Address - Street 1:5807 N FIGUEROA ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-4227
Mailing Address - Country:US
Mailing Address - Phone:323-982-0999
Mailing Address - Fax:323-982-0333
Practice Address - Street 1:5807 N FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-4227
Practice Address - Country:US
Practice Address - Phone:323-982-0999
Practice Address - Fax:323-982-0333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA398621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty