Provider Demographics
NPI:1679983498
Name:FARID SEHATI DDS INC.
Entity type:Organization
Organization Name:FARID SEHATI DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARID
Authorized Official - Middle Name:R
Authorized Official - Last Name:SEHATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-482-9568
Mailing Address - Street 1:484 MOBIL AVE STE 33
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6364
Mailing Address - Country:US
Mailing Address - Phone:805-482-9568
Mailing Address - Fax:805-482-9568
Practice Address - Street 1:484 MOBIL AVE STE 33
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6364
Practice Address - Country:US
Practice Address - Phone:805-482-9568
Practice Address - Fax:805-482-9568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA381601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty