Provider Demographics
NPI:1982652053
Name:HARIRI, PAYAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAYAM
Middle Name:
Last Name:HARIRI
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 1:2021B EMMORTON RD
Mailing Address - Street 2:STE 222
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-8980
Mailing Address - Country:US
Mailing Address - Phone:410-569-9100
Mailing Address - Fax:410-569-9200
Practice Address - Street 1:2021B EMMORTON RD
Practice Address - Street 2:STE 222
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-8980
Practice Address - Country:US
Practice Address - Phone:410-569-9100
Practice Address - Fax:410-569-9200
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD114071223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics