Provider Demographics
NPI:1710927165
Name:YAVARI, JAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAVID
Middle Name:
Last Name:YAVARI
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 1:2706 ABBEY CT.
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30092-3082
Mailing Address - Country:US
Mailing Address - Phone:770-664-1999
Mailing Address - Fax:770-664-7706
Practice Address - Street 1:3294 MEDLOCK BRIDGE RD
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-3082
Practice Address - Country:US
Practice Address - Phone:770-448-8882
Practice Address - Fax:770-446-5511
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0114241223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics