Healthcare Provider Details

I. General information

NPI: 1265636351
Provider Name (Legal Business Name): FERI AFSHAR, D.D.S., M.S., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1687 ERRINGER RD SUITE 207
SIMI VALLEY CA
93065-6508
US

IV. Provider business mailing address

1687 ERRINGER RD SUITE 207
SIMI VALLEY CA
93065-6508
US

V. Phone/Fax

Practice location:
  • Phone: 805-584-8444
  • Fax: 805-584-3847
Mailing address:
  • Phone: 805-584-8444
  • Fax: 805-584-3847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number032526
License Number StateCA

VIII. Authorized Official

Name: DR. FERI D AFSHAR
Title or Position: DENTIST
Credential: D.D.S., M.S.
Phone: 805-584-8444