Provider Demographics
NPI:1689879454
Name:HOJREH, VAHID (DMD)
Entity Type:Individual
Prefix:
First Name:VAHID
Middle Name:
Last Name:HOJREH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:VINNIE
Other - Middle Name:
Other - Last Name:HOJREH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:6740 W CAMELBACK RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85303-6307
Mailing Address - Country:US
Mailing Address - Phone:623-247-5300
Mailing Address - Fax:623-247-1826
Practice Address - Street 1:6740 W CAMELBACK RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85303-6307
Practice Address - Country:US
Practice Address - Phone:623-247-5300
Practice Address - Fax:623-247-1826
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4628122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ414805OtherAHCCCS