Provider Demographics
NPI:1992866362
Name:ZAMANIAN, MAHNAZ (DDS)
Entity Type:Individual
Prefix:
First Name:MAHNAZ
Middle Name:
Last Name:ZAMANIAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1299 156TH AVE NE
Mailing Address - Street 2:#115
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007
Mailing Address - Country:US
Mailing Address - Phone:425-614-1600
Mailing Address - Fax:425-614-1612
Practice Address - Street 1:1299 156TH AVE NE
Practice Address - Street 2:#115
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007
Practice Address - Country:US
Practice Address - Phone:425-614-1600
Practice Address - Fax:425-614-1612
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000081321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5037783Medicaid