DR. NAVID FARDANESH D.D.S
NPI 1174541908
Dentist - General Practice in San Luis Obispo, CA

Q: What is Navid Fardanesh's NPI number?

The NPI number for Navid Fardanesh is 1174541908. It was assigned to this individual provider in the NPPES registry on July 18, 2006.

Q: What is Navid Fardanesh's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Navid Fardanesh was last updated on February 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 18, 2006

2191 JOHNSON AVE, SAN LUIS OBISPO, CA 93401(805) 781-5503 Get Directions Write a Review

NPPES record last updated: February 26, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Navid Fardanesh D.d.s NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NAVID FARDANESH D.D.S (NPI 1174541908) is an individual general practice provider in San Luis Obispo, California, licensed in California (44587) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1174541908

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. NAVID FARDANESHCredential: D.D.S

Location Address2191 JOHNSON AVESan Luis Obispo, CA 93401-4534

Mailing Address2191 Johnson AveSan Luis Obispo, CA 93401-4534 · (805) 781-5503 · Fax (805) 781-5503

Phone(805) 781-5503

Sole ProprietorYes

Enumeration DateJuly 18, 2006

Last NPPES UpdateFebruary 26, 2016

✔ NPI 1174541908 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CA · 44587

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

2191 JOHNSON AVE, San Luis Obispo, CA 93401

Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. IRENE E. VEGA RN, PHN

Registered Nurse (Administrator)