Provider Demographics
NPI:1457533556
Name:RASSIWALA, FARHANA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:FARHANA
Middle Name:M
Last Name:RASSIWALA
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 1:4133 BANDINI CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-8739
Mailing Address - Country:US
Mailing Address - Phone:925-872-0050
Mailing Address - Fax:925-905-5428
Practice Address - Street 1:4133 BANDINI CT
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-8739
Practice Address - Country:US
Practice Address - Phone:925-872-0050
Practice Address - Fax:925-905-5428
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54852122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist