Provider Demographics
NPI:1346220795
Name:NAJAFI, POONEH (DDS)
Entity Type:Individual
Prefix:DR
First Name:POONEH
Middle Name:
Last Name:NAJAFI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3980 BOAT CLUB RD
Mailing Address - Street 2:STE. 114
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76135-3208
Mailing Address - Country:US
Mailing Address - Phone:817-237-1600
Mailing Address - Fax:817-237-2604
Practice Address - Street 1:3980 BOAT CLUB RD
Practice Address - Street 2:STE. 114
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76135-3208
Practice Address - Country:US
Practice Address - Phone:817-237-1600
Practice Address - Fax:817-237-2604
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX200851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice