Provider Demographics
NPI:1144606690
Name:OSTOVAR, MERAT B (DMD)
Entity Type:Individual
Prefix:MR
First Name:MERAT
Middle Name:B
Last Name:OSTOVAR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7546 NE SHALEEN ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124
Mailing Address - Country:US
Mailing Address - Phone:503-614-0198
Mailing Address - Fax:503-614-0202
Practice Address - Street 1:7546 NE SHALEEN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124
Practice Address - Country:US
Practice Address - Phone:503-614-0198
Practice Address - Fax:503-614-0202
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-07
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD10459122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist