Provider Demographics
NPI:1174351795
Name:JAFARYAN, ANIA (DDS)
Entity type:Individual
Prefix:DR
First Name:ANIA
Middle Name:
Last Name:JAFARYAN
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 1:99 TALISMAN APT 823
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-3861
Mailing Address - Country:US
Mailing Address - Phone:858-405-5844
Mailing Address - Fax:
Practice Address - Street 1:99 TALISMAN APT 823
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-3861
Practice Address - Country:US
Practice Address - Phone:858-405-5844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program