Provider Demographics
NPI:1992821334
Name:SARAFIAN, FARDIN DEAN (DDS)
Entity type:Individual
Prefix:
First Name:FARDIN
Middle Name:DEAN
Last Name:SARAFIAN
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 1:369 S DOHENY DR
Mailing Address - Street 2:#407
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211
Mailing Address - Country:US
Mailing Address - Phone:310-777-0464
Mailing Address - Fax:310-388-5414
Practice Address - Street 1:369 S DOHENY DR
Practice Address - Street 2:#407
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211
Practice Address - Country:US
Practice Address - Phone:310-777-0464
Practice Address - Fax:310-388-5414
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA382411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice