Provider Demographics
NPI:1841989845
Name:BAHRAM, CYRUS HESSAM (DMD)
Entity type:Individual
Prefix:
First Name:CYRUS
Middle Name:HESSAM
Last Name:BAHRAM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3090 E HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-9441
Mailing Address - Country:US
Mailing Address - Phone:704-732-2629
Mailing Address - Fax:
Practice Address - Street 1:3090 E HIGHWAY 27 STE A
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-9408
Practice Address - Country:US
Practice Address - Phone:704-732-2629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC141581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice