Provider Demographics
NPI:1366749400
Name:FARNIA, MAHYA (DMD)
Entity type:Individual
Prefix:DR
First Name:MAHYA
Middle Name:
Last Name:FARNIA
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 1:2001 W WASHINGTON ST
Mailing Address - Street 2:2001 WEST WASHINGTON ST
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-4299
Mailing Address - Country:US
Mailing Address - Phone:317-709-8512
Mailing Address - Fax:
Practice Address - Street 1:2001 W WASHINGTON ST
Practice Address - Street 2:2001 WEST WASHINGTON ST
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-4299
Practice Address - Country:US
Practice Address - Phone:317-709-8512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011513A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist