=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841990918
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAFARINEJAD & SEIFI DMD INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2023
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8835 N CEDAR AVE
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93720-1832
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-319-0505
-----------------------------------------------------
Fax | 559-319-0533
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1423 E CARLYLE WAY
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93730-3579
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-735-4480
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT
-----------------------------------------------------
Name | SANAZ SEIFI
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 949-735-4480
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223D0001X
-----------------------------------------------------
Taxonomy Name | Public Health Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------