Provider Demographics
NPI:1619130762
Name:NOORI, AFSANEH SAMIMI (DDS)
Entity Type:Individual
Prefix:DR
First Name:AFSANEH
Middle Name:SAMIMI
Last Name:NOORI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 FILLMORE ST
Mailing Address - Street 2:UNIT 201
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4358
Mailing Address - Country:US
Mailing Address - Phone:317-532-7443
Mailing Address - Fax:
Practice Address - Street 1:501 28TH ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-3003
Practice Address - Country:US
Practice Address - Phone:303-436-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO103791223G0001X
IN12011370A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice