Provider Demographics
NPI:1982821146
Name:DINYARIAN, PARVIN (DDS PA)
Entity Type:Individual
Prefix:MRS
First Name:PARVIN
Middle Name:
Last Name:DINYARIAN
Suffix:
Gender:F
Credentials:DDS PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14615 SAN PEDRO AVE
Mailing Address - Street 2:STE 218
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232
Mailing Address - Country:US
Mailing Address - Phone:210-495-6710
Mailing Address - Fax:210-490-8197
Practice Address - Street 1:14615 SAN PEDRO AVE
Practice Address - Street 2:STE 218
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232
Practice Address - Country:US
Practice Address - Phone:210-495-6710
Practice Address - Fax:210-490-8197
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16180122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1742149OtherUNITED CONCORDIA