Provider Demographics
NPI:1063549111
Name:FARHAD FARBOD DMD,P.C.
Entity type:Organization
Organization Name:FARHAD FARBOD DMD,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FARHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:FARBOD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:303-699-9880
Mailing Address - Street 1:14991 E HAMPDEN AVE STE 270
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3986
Mailing Address - Country:US
Mailing Address - Phone:303-699-9880
Mailing Address - Fax:303-699-9882
Practice Address - Street 1:14991 E HAMPDEN AVE STE 270
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3986
Practice Address - Country:US
Practice Address - Phone:303-699-9880
Practice Address - Fax:303-699-9882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO-6611122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO=========OtherTIN