Provider Demographics
NPI:1528806536
Name:FARAHAT SMILES, PLLCC
Entity type:Organization
Organization Name:FARAHAT SMILES, PLLCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAHAT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:302-379-1497
Mailing Address - Street 1:10907 MOORHEAD CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-2710
Mailing Address - Country:US
Mailing Address - Phone:302-379-1497
Mailing Address - Fax:
Practice Address - Street 1:7926 W HILLSBOROUGH AVE STE B
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4600
Practice Address - Country:US
Practice Address - Phone:302-379-1497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental