Provider Demographics
NPI:1457838294
Name:LOTFIZADEH DEHKORDI, NARGES (DDS)
Entity Type:Individual
Prefix:DR
First Name:NARGES
Middle Name:
Last Name:LOTFIZADEH DEHKORDI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:NARGES
Other - Middle Name:
Other - Last Name:LOTFI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:925 110TH AVE NE APT 309
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4481
Mailing Address - Country:US
Mailing Address - Phone:925-639-9442
Mailing Address - Fax:
Practice Address - Street 1:5605 LAKEWOOD TOWNE CENTER BLVD SW STE B
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-3855
Practice Address - Country:US
Practice Address - Phone:253-200-4706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60874723122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist