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General NPI Number Information
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NPI Number | 1780389486
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Entity Type | Individual
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Provider Name | DR. ALI SINA FARHADI
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Gender | Male
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Dates
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Enumeration Date | 04/03/2023
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 86TH MEDICAL GROUP / RAMSTEIN AIR BASE UNIT 3215 APO AE
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City | RAMSTEIN GEMEINDE RAMSTEIN-MIESENBACH
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State | GERMANY
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Zip | 09094
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Country | DE
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Telephone | 496-371-4062
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Fax |
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Provider Business Mailing Address
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Address Line | 205 TIMBERIDGE DR
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City | SAINT PETERS
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State | MO
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Zip | 63376-6751
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Country | US
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Telephone | 314-766-2747
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901601828
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License Number State | MI
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