Provider Demographics
NPI:1770760498
Name:SOLEIMANI, FARNAZ FARRAH (DDS)
Entity type:Individual
Prefix:
First Name:FARNAZ
Middle Name:FARRAH
Last Name:SOLEIMANI
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 1:8632 SEPULVEDA BLVD
Mailing Address - Street 2:#205
Mailing Address - City:LA
Mailing Address - State:CA
Mailing Address - Zip Code:90045
Mailing Address - Country:US
Mailing Address - Phone:310-338-0444
Mailing Address - Fax:360-342-0202
Practice Address - Street 1:8632 SEPULVEDA BLVD
Practice Address - Street 2:#205
Practice Address - City:LA
Practice Address - State:CA
Practice Address - Zip Code:90045
Practice Address - Country:US
Practice Address - Phone:310-338-0444
Practice Address - Fax:360-342-0202
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42001122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist