Provider Demographics
NPI:1588410724
Name:AYAZI, DARIYAN (DDS)
Entity type:Individual
Prefix:
First Name:DARIYAN
Middle Name:
Last Name:AYAZI
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 1:18834 HATTERAS ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-1366
Mailing Address - Country:US
Mailing Address - Phone:818-389-8436
Mailing Address - Fax:
Practice Address - Street 1:18834 HATTERAS ST UNIT B
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-1366
Practice Address - Country:US
Practice Address - Phone:818-389-8436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110048122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist