Provider Demographics
NPI:1801826995
Name:BARGHOUTI, TARIQ (DDS)
Entity Type:Individual
Prefix:DR
First Name:TARIQ
Middle Name:
Last Name:BARGHOUTI
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 1:14201 NE 20TH AVEUE
Mailing Address - Street 2:SUITE 2204
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686
Mailing Address - Country:US
Mailing Address - Phone:360-571-8181
Mailing Address - Fax:360-573-4029
Practice Address - Street 1:5880 NE CORNELL RD
Practice Address - Street 2:SUITE D
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-9075
Practice Address - Country:US
Practice Address - Phone:503-615-8600
Practice Address - Fax:503-681-8691
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD68441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice