Provider Demographics
NPI:1447613799
Name:KIANOOSH BEHSHID DDS PLLC
Entity Type:Organization
Organization Name:KIANOOSH BEHSHID DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIANOOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHSHID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-558-0909
Mailing Address - Street 1:2661 BEL RED RD
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-2200
Mailing Address - Country:US
Mailing Address - Phone:425-558-0909
Mailing Address - Fax:425-895-0150
Practice Address - Street 1:2661 BEL RED RD
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-2200
Practice Address - Country:US
Practice Address - Phone:425-558-0909
Practice Address - Fax:425-895-0150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000099851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty