Provider Demographics
NPI:1013247394
Name:SHADI MOHAMMADI ARAGHI PLLC
Entity Type:Organization
Organization Name:SHADI MOHAMMADI ARAGHI PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHADI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-577-0949
Mailing Address - Street 1:2520 NE PARK DRIVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029
Mailing Address - Country:US
Mailing Address - Phone:425-996-0457
Mailing Address - Fax:
Practice Address - Street 1:2520 NE PARK DRIVE
Practice Address - Street 2:SUITE C
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029
Practice Address - Country:US
Practice Address - Phone:425-996-0457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000108711223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty