Provider Demographics
NPI:1225481062
Name:NAGHMEH J IZADI, DMD
Entity Type:Organization
Organization Name:NAGHMEH J IZADI, DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NAGHMEH
Authorized Official - Middle Name:J
Authorized Official - Last Name:IZADI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:425-774-7794
Mailing Address - Street 1:4100 194TH ST SW STE 210
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4613
Mailing Address - Country:US
Mailing Address - Phone:425-774-7794
Mailing Address - Fax:
Practice Address - Street 1:4100 194TH ST SW STE 210
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4613
Practice Address - Country:US
Practice Address - Phone:425-774-7794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-17
Last Update Date:2016-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty