Provider Demographics
NPI:1982621942
Name:FARZANEH, KIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIAN
Middle Name:
Last Name:FARZANEH
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 1:801 SAN RAMON VALLEY BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-4027
Mailing Address - Country:US
Mailing Address - Phone:925-831-9217
Mailing Address - Fax:925-831-9218
Practice Address - Street 1:801 SAN RAMON VALLEY BLVD STE A
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4027
Practice Address - Country:US
Practice Address - Phone:925-831-9217
Practice Address - Fax:925-831-9218
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA465871223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery