Provider Demographics
NPI:1790404796
Name:SHARIATI, FARNIA (DMD)
Entity type:Individual
Prefix:DR
First Name:FARNIA
Middle Name:
Last Name:SHARIATI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 ANGIER AVE NE APT 344
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-3181
Mailing Address - Country:US
Mailing Address - Phone:850-510-8617
Mailing Address - Fax:
Practice Address - Street 1:2859 PACES FERRY RD SE STE 530
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-6221
Practice Address - Country:US
Practice Address - Phone:678-355-8980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN122856122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist