Provider Demographics
NPI:1407080997
Name:ZARTOSHTY, DARYOUSH
Entity Type:Individual
Prefix:DR
First Name:DARYOUSH
Middle Name:
Last Name:ZARTOSHTY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4433 TURTLE CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2154
Mailing Address - Country:US
Mailing Address - Phone:859-536-0774
Mailing Address - Fax:
Practice Address - Street 1:2036 REGENCY RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2309
Practice Address - Country:US
Practice Address - Phone:859-277-6234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8250122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist