Provider Demographics
NPI:1972725406
Name:BAYAT, ANGELA FERESHTEH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:FERESHTEH
Last Name:BAYAT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ALTARINDA RD STE 305
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-2601
Mailing Address - Country:US
Mailing Address - Phone:625-254-0084
Mailing Address - Fax:
Practice Address - Street 1:3021 TELEGRAPH AVE. SUITE D
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705
Practice Address - Country:US
Practice Address - Phone:510-841-1866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA465571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice