Healthcare Provider Details

I. General information

NPI: 1063321156
Provider Name (Legal Business Name): FARAZ FARAHNIK INC. APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16260 VENTURA BLVD STE 730
ENCINO CA
91436-2260
US

IV. Provider business mailing address

16260 VENTURA BLVD STE 730
ENCINO CA
91436-2260
US

V. Phone/Fax

Practice location:
  • Phone: 818-514-2228
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. FARAZ FARAHNIK
Title or Position: OWNER
Credential: DDS
Phone: 310-500-6278