Provider Demographics
NPI:1972862183
Name:VAHIDNIA, ARMIN
Entity Type:Individual
Prefix:MR
First Name:ARMIN
Middle Name:
Last Name:VAHIDNIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2085 SACRAMENTO ST APT 508
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-3319
Mailing Address - Country:US
Mailing Address - Phone:925-899-9762
Mailing Address - Fax:
Practice Address - Street 1:2813 109TH AVE SE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-7538
Practice Address - Country:US
Practice Address - Phone:925-899-9762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE609601521223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics