Provider Demographics
NPI:1598289464
Name:AUSTIN, CYRUS FARAMROZE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CYRUS
Middle Name:FARAMROZE
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 W. MCNAIR ST.
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:65225
Mailing Address - Country:US
Mailing Address - Phone:480-284-8017
Mailing Address - Fax:
Practice Address - Street 1:1100 BOWLING RD.
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AZ
Practice Address - Zip Code:85132
Practice Address - Country:US
Practice Address - Phone:520-868-9095
Practice Address - Fax:520-868-5272
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD03280122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty