Individual
DR. MAHDOKHT A. FARAHANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
825 EUCLID AVE, KANSAS CITY, MO 64124-2323
(816) 474-4920
(816) 889-1845
Mailing address
825 EUCLID AVE, KANSAS CITY, MO 64124-2323
(816) 474-4920
(816) 889-1845
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
25290
TX
122300000X
Dentist
60698
KS
1223G0001X
General Practice Dentistry
Primary
2009013192
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200734870A
—
MO
01
—
2009013192
MISSOURI DENTAL BOARD
MO
01
—
60698
KANSAS DENTAL BOARD
KS
01
—
C16000024
MEDICARE PTAN
MO
01
—
G0172817
DPS
TX
Enumeration date
08/12/2010
Last updated
03/07/2023
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