Provider Demographics
NPI:1598983165
Name:IRANPOUR, SAFA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAFA
Middle Name:
Last Name:IRANPOUR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:STEVEN
Other - Middle Name:SAFA
Other - Last Name:IRANPOUR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:4370 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:OH
Mailing Address - Zip Code:44144-2717
Mailing Address - Country:US
Mailing Address - Phone:216-749-0747
Mailing Address - Fax:216-739-9544
Practice Address - Street 1:4370 RIDGE RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:OH
Practice Address - Zip Code:44144-2717
Practice Address - Country:US
Practice Address - Phone:216-749-0747
Practice Address - Fax:216-739-9544
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH19430122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist