Provider Demographics
NPI:1730229501
Name:SAFARYAN, ERNA (DDS)
Entity type:Individual
Prefix:DR
First Name:ERNA
Middle Name:
Last Name:SAFARYAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6856 GRAY GABLES LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4243
Mailing Address - Country:US
Mailing Address - Phone:614-734-1217
Mailing Address - Fax:
Practice Address - Street 1:6075 CLEVELAND AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-2242
Practice Address - Country:US
Practice Address - Phone:614-899-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH218481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice