Provider Demographics
NPI:1114578069
Name:JAVID OSAFI DMD PLLC
Entity Type:Organization
Organization Name:JAVID OSAFI DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVID
Authorized Official - Middle Name:FARAN
Authorized Official - Last Name:OSAFI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:425-223-3522
Mailing Address - Street 1:324 102ND AVE SE APT 308
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-8109
Mailing Address - Country:US
Mailing Address - Phone:425-223-3522
Mailing Address - Fax:425-659-3131
Practice Address - Street 1:19020 BOTHELL WAY NE STE C
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-2996
Practice Address - Country:US
Practice Address - Phone:425-659-1200
Practice Address - Fax:425-659-3131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty