Provider Demographics
NPI:1932640463
Name:FARINOUSH GAMINCHI DMD INC
Entity Type:Organization
Organization Name:FARINOUSH GAMINCHI DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FARINOUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMINCHI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:310-829-3898
Mailing Address - Street 1:1304 15TH ST
Mailing Address - Street 2:STE 315
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-1809
Mailing Address - Country:US
Mailing Address - Phone:310-829-3898
Mailing Address - Fax:310-829-0443
Practice Address - Street 1:1304 15TH ST
Practice Address - Street 2:STE 315
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1809
Practice Address - Country:US
Practice Address - Phone:310-829-3898
Practice Address - Fax:310-829-0443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty