Provider Demographics
NPI:1871682427
Name:FIROUZI, BABAK (DMD)
Entity Type:Individual
Prefix:
First Name:BABAK
Middle Name:
Last Name:FIROUZI
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 1:250 MOUNT LEBANON BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15234-1252
Mailing Address - Country:US
Mailing Address - Phone:412-344-7755
Mailing Address - Fax:412-344-7798
Practice Address - Street 1:250 MOUNT LEBANON BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15234-1252
Practice Address - Country:US
Practice Address - Phone:412-344-7755
Practice Address - Fax:412-344-7798
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-030078-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice