Provider Demographics
NPI:1548442015
Name:FARZAN, SARAH FARNAZ (DDS)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:FARNAZ
Last Name:FARZAN
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 1:814 N ALPINE DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-2902
Mailing Address - Country:US
Mailing Address - Phone:310-968-6484
Mailing Address - Fax:310-858-1192
Practice Address - Street 1:814 N ALPINE DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-2902
Practice Address - Country:US
Practice Address - Phone:310-968-6484
Practice Address - Fax:310-858-1192
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA555471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice