Provider Demographics
NPI:1760818520
Name:SMILES OF BEAUTY OF EL MIRAGE, PC
Entity Type:Organization
Organization Name:SMILES OF BEAUTY OF EL MIRAGE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEYRAMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:623-557-5444
Mailing Address - Street 1:10111 N EL MIRAGE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:EL MIRAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85335-3605
Mailing Address - Country:US
Mailing Address - Phone:623-551-5444
Mailing Address - Fax:623-935-3777
Practice Address - Street 1:10111 N EL MIRAGE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:EL MIRAGE
Practice Address - State:AZ
Practice Address - Zip Code:85335-3605
Practice Address - Country:US
Practice Address - Phone:623-551-5444
Practice Address - Fax:623-935-3777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD63731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty