Brookvale Family Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

38565 Issued in CA

Legal business name

BROOKVALE FAMILY DENTISTRY

Practice address

39236 Argonaut Way
Fremont, CA 94538-1306

Phone

(510) 739-0701

NPI assigned

Dec 31, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Farshad Moftakhar

Title

Owner

Phone

(310) 274-7485

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199404800000",
    "number": "1447435250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9025 WILSHIRE BLVD",
            "address_2": "STE 315",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39236 ARGONAUT WAY",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381306",
            "telephone_number": "510-739-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKVALE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-31",
        "last_updated": "2008-01-04",
        "status": "A",
        "authorized_official_last_name": "MOFTAKHAR",
        "authorized_official_first_name": "FARSHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-274-7485"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "38565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marta Schneider Brody, PH.D.
• Cynthia Kibrick Bromberg, PHD
• Jeffrey Bromberg, PH.D.
• Albert L. Brooks, M.D.
• Matthew Joel Brooks, NP
• Betty Brown, MA
• Judith R. Brown, PH.D.
• Kathleen Suzanne Brown, MFT
• Kayla Brown
• Lisa Catherine Brown

• Dentist in Fremont, CA
• Providers in Fremont, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.