Provider Demographics
NPI:1083102396
Name:REZA SAFFARI, DMD, PLLC
Entity Type:Organization
Organization Name:REZA SAFFARI, DMD, PLLC
Other - Org Name:DENTAL DESIGNS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REZA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAFFARI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-753-6675
Mailing Address - Street 1:900 SE CHKALOV DR
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-5240
Mailing Address - Country:US
Mailing Address - Phone:360-896-1449
Mailing Address - Fax:
Practice Address - Street 1:900 SE CHKALOV DR
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-5240
Practice Address - Country:US
Practice Address - Phone:360-896-1449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty