Provider Demographics
NPI:1942229067
Name:ARZEGAR, REZA (DDS)
Entity Type:Individual
Prefix:DR
First Name:REZA
Middle Name:
Last Name:ARZEGAR
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 1:4631 AIRPORT BLVD
Mailing Address - Street 2:SUITE#120A
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-3453
Mailing Address - Country:US
Mailing Address - Phone:512-371-8858
Mailing Address - Fax:512-371-8860
Practice Address - Street 1:4631 AIRPORT BLVD
Practice Address - Street 2:SUITE#120A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-3453
Practice Address - Country:US
Practice Address - Phone:512-371-8858
Practice Address - Fax:512-371-8860
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX224341223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry