Provider Demographics
NPI:1528624962
Name:ASHRAFIAN, SANAZ F (RDH)
Entity type:Individual
Prefix:
First Name:SANAZ
Middle Name:F
Last Name:ASHRAFIAN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5390 W 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:CO
Mailing Address - Zip Code:80214-1244
Mailing Address - Country:US
Mailing Address - Phone:818-522-3960
Mailing Address - Fax:
Practice Address - Street 1:5390 W 25TH AVE
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:CO
Practice Address - Zip Code:80214-1244
Practice Address - Country:US
Practice Address - Phone:818-522-3960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH.002025178124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist