Provider Demographics
NPI:1881895571
Name:AZARINFAR, FARAMARZ ANDRE (DDS)
Entity type:Individual
Prefix:DR
First Name:FARAMARZ
Middle Name:ANDRE
Last Name:AZARINFAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39340 FREMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1320
Mailing Address - Country:US
Mailing Address - Phone:510-651-7700
Mailing Address - Fax:
Practice Address - Street 1:129 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-4001
Practice Address - Country:US
Practice Address - Phone:415-362-1850
Practice Address - Fax:415-362-5912
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS 460221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice