Provider Demographics
NPI:1982682951
Name:FARROKH, AARON REZA (DMD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:REZA
Last Name:FARROKH
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 E CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-2533
Mailing Address - Country:US
Mailing Address - Phone:860-667-0875
Mailing Address - Fax:860-666-0570
Practice Address - Street 1:59 E CEDAR ST
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-2533
Practice Address - Country:US
Practice Address - Phone:860-667-0875
Practice Address - Fax:860-666-0857
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0095761223G0001X
NY0508271122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice