Provider Demographics
NPI:1467662478
Name:RANDJI, AKBAR K (DENTURIST)
Entity Type:Individual
Prefix:
First Name:AKBAR
Middle Name:K
Last Name:RANDJI
Suffix:
Gender:M
Credentials:DENTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 WARNER MILNE RD
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-4043
Mailing Address - Country:US
Mailing Address - Phone:503-655-4007
Mailing Address - Fax:
Practice Address - Street 1:279 WARNER MILNE RD
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-4043
Practice Address - Country:US
Practice Address - Phone:503-655-4007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0516741979122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist