Organization
CENTER FOR FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FARIBA SHARIFAN (DMD)
(973) 375-0400
Entity
Organization
Contact information
Practice address
1187 CLINTON AVE, IRVINGTON, NJ 07111
(973) 375-0400
Mailing address
1187 CLINTON AVE, IRVINGTON, NJ 07111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DI020295
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000299601
AMERICHOICE
NJ
05
—
0110221-01
—
NJ
01
—
011070
DORAL DENTAL
NJ
01
—
60025186
HORIZON NJ HEALTH
NJ
Enumeration date
10/30/2008
Last updated
11/06/2008
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