Provider Demographics
NPI:1457903387
Name:GOLDFARB, BRIAN STEVEN (DMD, MSD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:STEVEN
Last Name:GOLDFARB
Suffix:
Gender:M
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 E GREENWAY RD # SET2
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-1653
Mailing Address - Country:US
Mailing Address - Phone:215-595-3305
Mailing Address - Fax:
Practice Address - Street 1:4910 E GREENWAY RD STE 2
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-1653
Practice Address - Country:US
Practice Address - Phone:602-404-4458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-11
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0113541223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics