Provider Demographics
NPI:1811002751
Name:RAOUFI, DEYDOKHT (DDS)
Entity Type:Individual
Prefix:
First Name:DEYDOKHT
Middle Name:
Last Name:RAOUFI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:LIDA
Other - Middle Name:
Other - Last Name:RAOUFI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:14201 N HAYDEN DRIVE
Mailing Address - Street 2:D3
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260
Mailing Address - Country:US
Mailing Address - Phone:480-998-4867
Mailing Address - Fax:480-998-4872
Practice Address - Street 1:14201 N HAYDEN DRIVE
Practice Address - Street 2:SUITE D3
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-998-4867
Practice Address - Fax:480-998-4872
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD5320122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist