Provider Demographics
NPI:1144228602
Name:SAMANI, PARI (DMD)
Entity Type:Individual
Prefix:
First Name:PARI
Middle Name:
Last Name:SAMANI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10465 SW DAVIES RD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-8018
Mailing Address - Country:US
Mailing Address - Phone:503-579-0288
Mailing Address - Fax:
Practice Address - Street 1:8375 SW WARM SPRINGS ST
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-9003
Practice Address - Country:US
Practice Address - Phone:503-885-8899
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:2006-03-15
Deactivation Code:
Reactivation Date:2006-04-05
Provider Licenses
StateLicense IDTaxonomies
ORD69921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice