Provider Demographics
NPI:1629833827
Name:BEHNAZ SEPEHRIPOUR DD, A PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:BEHNAZ SEPEHRIPOUR DD, A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BEHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NARAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-554-5200
Mailing Address - Street 1:331 W HARWOOD RD STE A
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3048
Mailing Address - Country:US
Mailing Address - Phone:817-431-6995
Mailing Address - Fax:
Practice Address - Street 1:331 W HARWOOD RD STE A
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3048
Practice Address - Country:US
Practice Address - Phone:817-431-6995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty