Provider Demographics
NPI:1154839165
Name:CYRUS PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:CYRUS PROFESSIONAL CORPORATION
Other - Org Name:WE ARE SMILES/ TONY HASHEMIAN, DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBLEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-864-1119
Mailing Address - Street 1:2401 W. GLENDALE AVE.
Mailing Address - Street 2:STE 102
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021
Mailing Address - Country:US
Mailing Address - Phone:602-864-1119
Mailing Address - Fax:602-680-5038
Practice Address - Street 1:2401 W. GLENDALE AVE
Practice Address - Street 2:STE 102
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021
Practice Address - Country:US
Practice Address - Phone:602-864-1119
Practice Address - Fax:602-680-5038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-12
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD04970122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty