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General NPI Number Information
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NPI Number | 1386731305
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Entity Type | Organization
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Legal Business Name | FARZAD FIROUZIAN DDS PA
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 10/11/2018
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Provider Practice Location Address
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Address Line | 1 E CAMPUS VIEW BLVD
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City | COLUMBUS
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State | OH
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Zip | 43235-5691
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Country | US
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Telephone | 614-848-5001
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Fax | 614-848-5003
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Provider Business Mailing Address
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Address Line | 1 EAST CAMPUS VIEW BLVD
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City | COLUMBUS
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State | OH
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Zip | 43235
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Country | US
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Telephone | 614-848-5001
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Fax | 614-848-5003
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Authorized Official
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Title or Position | DENTIST
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Name | DR. FARZAD MICHAEL FIROUZIAN
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Credential | DDS, M.A., F.A.G.D.
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Telephone | 614-848-5001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 19415
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License Number State | OH
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