Provider Demographics
NPI:1750518734
Name:VAFAI, FATIMA (DDS)
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:VAFAI
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 1:4748 RASPBERRY PL
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-1935
Mailing Address - Country:US
Mailing Address - Phone:408-569-1251
Mailing Address - Fax:
Practice Address - Street 1:888 SARATOGA AVE STE 102
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-2639
Practice Address - Country:US
Practice Address - Phone:408-569-1251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54429122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist