Provider Demographics
NPI:1316054240
Name:MARFATIA, RIKIM A (DDS)
Entity type:Individual
Prefix:DR
First Name:RIKIM
Middle Name:A
Last Name:MARFATIA
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 1:86 HAZELTON
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-2189
Mailing Address - Country:US
Mailing Address - Phone:949-429-5444
Mailing Address - Fax:
Practice Address - Street 1:24310 MOULTON PKWY
Practice Address - Street 2:
Practice Address - City:LAGUNA WOODS
Practice Address - State:CA
Practice Address - Zip Code:92637-3306
Practice Address - Country:US
Practice Address - Phone:949-859-3988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA483271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice