Provider Demographics
NPI:1952566820
Name:GELMAN, FAINA (DDS)
Entity type:Individual
Prefix:
First Name:FAINA
Middle Name:
Last Name:GELMAN
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 1:11273 LAUREL CANYON BLVD
Mailing Address - Street 2:#3
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340-4300
Mailing Address - Country:US
Mailing Address - Phone:310-995-4465
Mailing Address - Fax:
Practice Address - Street 1:11273 LAUREL CANYON BLVD
Practice Address - Street 2:#3
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-4300
Practice Address - Country:US
Practice Address - Phone:310-995-4465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA549881223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry